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Pancoast syndrome

MedGen UID:
10553
•Concept ID:
C0030271
•
Neoplastic Process
Synonyms: Pancoast Syndrome; Pancoast's Syndrome; Pancoasts Syndrome; Syndrome, Pancoast; Syndrome, Pancoast's
SNOMED CT: Pancoast syndrome (278065000); Superior pulmonary sulcus syndrome (278065000); Pancoast's syndrome (278065000)
 
Monarch Initiative: MONDO:0024674

Definition

A rare neoplastic syndrome characterized by obstruction of the thoracic outlet leading to compression of the brachial plexus and vessels within. It is usually caused by a malignant neoplasm in the superior pulmonary sulcus. The most commonly involved neoplasms are non-small cell lung carcinomas. Clinical signs include Horner''s syndrome, shoulder pain radiating down the arm in the ulnar distribution followed by edema and atrophy of the affected extremity. Clinical course usually leads to early local invasion of the bony thoracic structures. Prognosis is highly stage-dependent. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPancoast syndrome

Professional guidelines

PubMed

Pancoast tumours: clinical assessment and long-term results of combined radiosurgical treatment.
Muscolino G, Valente M, Andreani S
Thorax 1997 Mar;52(3):284-6. doi: 10.1136/thx.52.3.284. PMID: 9093348Free PMC Article
Management of pain associated with the Pancoast syndrome.
Batzdorf U, Brechner VL
Am J Surg 1979 May;137(5):638-46. doi: 10.1016/0002-9610(79)90038-2. PMID: 287389

Recent clinical studies

Etiology

A clinico-epidemiological, pathological, and molecular study of lung cancer in Northwestern India.
Darling HS, Viswanath S, Singh R, Ranjan S, Pathi N, Rathore A, Pathak A, Sud R
J Cancer Res Ther 2020 Jul-Sep;16(4):771-779. doi: 10.4103/jcrt.JCRT_473_17. PMID: 32930117
Management of locally advanced pancoast (superior sulcus) tumors with spine involvement.
Setzer M, Robinson LA, Vrionis FD
Cancer Control 2014 Apr;21(2):158-67. doi: 10.1177/107327481402100209. PMID: 24667403
Pancoast tumor: a modern perspective on an old problem.
Glassman LR, Hyman K
Curr Opin Pulm Med 2013 Jul;19(4):340-3. doi: 10.1097/MCP.0b013e3283621b31. PMID: 23702478
Multimodality therapy for Pancoast tumor.
Narayan S, Thomas CR Jr
Nat Clin Pract Oncol 2006 Sep;3(9):484-91. doi: 10.1038/ncponc0584. PMID: 16955087
Resection of superior sulcus carcinomas (anterior approach).
Macchiarini P
Thorac Surg Clin 2004 May;14(2):229-40. doi: 10.1016/S1547-4127(04)00008-8. PMID: 15382299

Diagnosis

Pancoast tumour: current therapeutic options.
Palumbo VD, Fazzotta S, Fatica F, D'Orazio B, Caronia FP, Cajozzo M, Damiano G, Maffongelli A, Cudia BM, Messina M, Lo Monte AI
Clin Ter 2019 Jul-Aug;170(4):e291-e294. doi: 10.7417/CT.2019.2150. PMID: 31304518
Management of Lung Cancer Invading the Superior Sulcus.
Kratz JR, Woodard G, Jablons DM
Thorac Surg Clin 2017 May;27(2):149-157. doi: 10.1016/j.thorsurg.2017.01.008. PMID: 28363369
Diagnosing and treating pancoast tumors.
Zarogoulidis K, Porpodis K, Domvri K, Eleftheriadou E, Ioannidou D, Zarogoulidis P
Expert Rev Respir Med 2016 Dec;10(12):1255-1258. Epub 2016 Oct 27 doi: 10.1080/17476348.2017.1246964. PMID: 27786592
Pancoast's syndrome secondary to infectious etiologies: a not so uncommon occurrence.
White HD, White BA, Boethel C, Arroliga AC
Am J Med Sci 2011 Apr;341(4):333-6. doi: 10.1097/MAJ.0b013e3181fa2e2d. PMID: 21030854
Superior sulcus tumors.
Wright CD, Mathisen DJ
Curr Treat Options Oncol 2001 Feb;2(1):43-9. doi: 10.1007/s11864-001-0015-7. PMID: 12057139

Therapy

Anatomic evaluation of Pancoast tumors using three-dimensional models for surgical strategy development.
Chen Z, Bernards N, Gregor A, Vannelli C, Kitazawa S, de Perrot M, Yasufuku K
J Thorac Cardiovasc Surg 2023 Mar;165(3):842-852.e5. Epub 2022 Sep 9 doi: 10.1016/j.jtcvs.2022.08.037. PMID: 36241449
Does induction chemoradiotherapy increase survival in patients with Pancoast tumour?
Buderi SI, Shackcloth M, Woolley S
Interact Cardiovasc Thorac Surg 2016 Nov;23(5):821-825. Epub 2016 Jun 29 doi: 10.1093/icvts/ivw216. PMID: 27365009
Superior sulcus tumors.
Wright CD, Mathisen DJ
Curr Treat Options Oncol 2001 Feb;2(1):43-9. doi: 10.1007/s11864-001-0015-7. PMID: 12057139
Pancoast tumors.
Vallières E, Karmy-Jones R, Mulligan MS, Wood DE
Curr Probl Surg 2001 May;38(5):293-376. doi: 10.1067/msg.2001.113528. PMID: 11332249
Intractable pain with lung cancer.
Watson PN, Evans RJ
Pain 1987 May;29(2):163-173. doi: 10.1016/0304-3959(87)91033-5. PMID: 3614955

Prognosis

Harlequin sign in Pancoast tumor.
Kumar R, Bhandari S, Kloecker GH
Curr Probl Cancer 2020 Apr;44(2):100506. Epub 2019 Nov 1 doi: 10.1016/j.currproblcancer.2019.100506. PMID: 31732238
Management of locally advanced pancoast (superior sulcus) tumors with spine involvement.
Setzer M, Robinson LA, Vrionis FD
Cancer Control 2014 Apr;21(2):158-67. doi: 10.1177/107327481402100209. PMID: 24667403
Surgical treatment of Pancoast tumours.
Pitz CC, de la Rivière AB, van Swieten HA, Duurkens VA, Lammers JW, van den Bosch JM
Eur J Cardiothorac Surg 2004 Jul;26(1):202-8. doi: 10.1016/j.ejcts.2004.02.016. PMID: 15201002
Pancoast tumors.
Vallières E, Karmy-Jones R, Mulligan MS, Wood DE
Curr Probl Surg 2001 May;38(5):293-376. doi: 10.1067/msg.2001.113528. PMID: 11332249
Pancoast tumors of the lung.
Jones DR, Detterbeck FC
Curr Opin Pulm Med 1998 Jul;4(4):191-7. doi: 10.1097/00063198-199807000-00001. PMID: 10813231

Clinical prediction guides

Influence of anterior tumor location on survival after resection of lung cancer invading the thoracic inlet (Pancoast tumors).
Tsitsias T, Yasufuku K, Pierre A, Leighl N, Cho J, Waddell TK, Darling G, Cypel M, Donahoe L, Yeung J, Keshavjee S, de Perrot M
J Thorac Cardiovasc Surg 2023 May;165(5):1710-1719.e3. Epub 2022 Nov 2 doi: 10.1016/j.jtcvs.2022.10.033. PMID: 36481062
A clinico-epidemiological, pathological, and molecular study of lung cancer in Northwestern India.
Darling HS, Viswanath S, Singh R, Ranjan S, Pathi N, Rathore A, Pathak A, Sud R
J Cancer Res Ther 2020 Jul-Sep;16(4):771-779. doi: 10.4103/jcrt.JCRT_473_17. PMID: 32930117
Surgical Treatment of Superior Sulcus Tumors: A 15-Year Single-center Experience.
Solli P, Casiraghi M, Brambilla D, Maisonneuve P, Spaggiari L
Semin Thorac Cardiovasc Surg 2017 Spring;29(1):79-88. Epub 2017 Feb 22 doi: 10.1053/j.semtcvs.2017.01.010. PMID: 28684003
Subclavian artery resection and reconstruction for thoracic inlet neoplasms.
Mercier O, Su XD, Lahon B, Mussot S, Fabre D, Delemos A, Le Chevalier T, Dartevelle PG, Fadel E
Chin Clin Oncol 2015 Dec;4(4):41. doi: 10.3978/j.issn.2304-3865.2015.12.08. PMID: 26730753
Eponyms in cardiothoracic radiology: Part I. Neoplasms.
Mohammed TL, Saettele MR, Saettele T, Patel V, Kanne JP
Curr Probl Diagn Radiol 2014 Mar-Apr;43(2):91-8. doi: 10.1067/j.cpradiol.2013.12.003. PMID: 24629662

Recent systematic reviews

Management of locally advanced pancoast (superior sulcus) tumors with spine involvement.
Setzer M, Robinson LA, Vrionis FD
Cancer Control 2014 Apr;21(2):158-67. doi: 10.1177/107327481402100209. PMID: 24667403

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