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Superior Sulcus Tumor
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Pancoast tumor
              • Definitions

                • Benign or malignant neoplasm extending to superior thoracic inlet with severe shoulder/arm pain along C8, T1, T2 nerve trunks, Horner syndrome, weakness + atrophy of intrinsic hand muscles (Pancoast syndrome)
                  • Non-small cell lung carcinoma (NSCLC) most frequent etiology

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Angiographic Findings

                        • Nonvascular Interventions

                          • Nuclear Medicine Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Staging, Grading, & Classification

                                    • Gross Pathologic & Surgical Features

                                      • Microscopic Features

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Demographics

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  Selected References

                                                  1. Nikolaos P et al: Therapeutic modalities for Pancoast tumors. J Thorac Dis. 6(Suppl 1):S180-93, 2014
                                                  2. Foroulis CN et al: Superior sulcus (Pancoast) tumors: current evidence on diagnosis and radical treatment. J Thorac Dis. 5(Suppl 4):S342-58, 2013
                                                  3. Manenti G et al: Pancoast tumor: the role of magnetic resonance imaging. Case Rep Radiol. 2013:479120, 2013
                                                  4. Younga J et al: Venous hemangioma presenting as a superior sulcus tumor. Ann Thorac Surg. 90(6):2033-5, 2010
                                                  5. Tamura M et al: Current treatment paradigms of superior sulcus tumours. Eur J Cardiothorac Surg. 36(4):747-53, 2009
                                                  6. Davis GA et al: Pancoast tumors. Neurosurg Clin N Am. 19(4):545-57, v-vi, 2008
                                                  7. Davis GA et al: Pancoast tumor resection with preservation of brachial plexus and hand function. Neurosurg Focus. 22(6):E15, 2007
                                                  8. Rusch VW: Management of Pancoast tumours. Lancet Oncol. 7(12):997-1005, 2006
                                                  9. Shah H et al: Brain: the common site of relapse in patients with pancoast or superior sulcus tumors. J Thorac Oncol. 1(9):1020-2, 2006
                                                  10. Archie VC et al: Superior sulcus tumors: a mini-review. Oncologist. 9(5):550-5, 2004
                                                  11. Huehnergarth KV et al: Superior pulmonary sulcus tumor with Pancoast syndrome. Mayo Clin Proc. 79(10):1268, 2004
                                                  12. Weyant MJ et al: Imaging of pleural and chest wall tumors. Thorac Surg Clin. 14(1):15-23, 2004
                                                  13. Beshay M et al: Tuberculosis presenting as Pancoast tumor. Ann Thorac Surg. 76(5):1733-5, 2003
                                                  14. Detterbeck FC et al: Lung cancer. Special treatment issues. Chest. 123(1 Suppl):244S-258S, 2003
                                                  15. Detterbeck FC: Changes in the treatment of Pancoast tumors. Ann Thorac Surg. 75(6):1990-7, 2003
                                                  16. Kichari JR et al: MR imaging of the brachial plexus: current imaging sequences, normal findings, and findings in a spectrum of focal lesions with MR-pathologic correlation. Curr Probl Diagn Radiol. 32(2):88-101, 2003
                                                  17. Dartevelle P et al: Surgical management of superior sulcus tumors. Oncologist. 4(5):398-407, 1999
                                                  18. Ducic Y et al: A logical approach to the thoracic inlet: the Dartevelle approach revisited. Head Neck. 21(8):767-71, 1999
                                                  19. Jones DR et al: Pancoast tumors of the lung. Curr Opin Pulm Med. 4(4):191-7, 1998
                                                  20. Kuhlman JE et al: CT and MR imaging evaluation of chest wall disorders. Radiographics. 14(3):571-95, 1994
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Pancoast tumor
                                                              • Definitions

                                                                • Benign or malignant neoplasm extending to superior thoracic inlet with severe shoulder/arm pain along C8, T1, T2 nerve trunks, Horner syndrome, weakness + atrophy of intrinsic hand muscles (Pancoast syndrome)
                                                                  • Non-small cell lung carcinoma (NSCLC) most frequent etiology

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Angiographic Findings

                                                                        • Nonvascular Interventions

                                                                          • Nuclear Medicine Findings

                                                                            • Imaging Recommendations

                                                                              DIFFERENTIAL DIAGNOSIS

                                                                                PATHOLOGY

                                                                                • General Features

                                                                                  • Staging, Grading, & Classification

                                                                                    • Gross Pathologic & Surgical Features

                                                                                      • Microscopic Features

                                                                                        CLINICAL ISSUES

                                                                                        • Presentation

                                                                                          • Demographics

                                                                                            • Natural History & Prognosis

                                                                                              • Treatment

                                                                                                DIAGNOSTIC CHECKLIST

                                                                                                • Consider

                                                                                                  Selected References

                                                                                                  1. Nikolaos P et al: Therapeutic modalities for Pancoast tumors. J Thorac Dis. 6(Suppl 1):S180-93, 2014
                                                                                                  2. Foroulis CN et al: Superior sulcus (Pancoast) tumors: current evidence on diagnosis and radical treatment. J Thorac Dis. 5(Suppl 4):S342-58, 2013
                                                                                                  3. Manenti G et al: Pancoast tumor: the role of magnetic resonance imaging. Case Rep Radiol. 2013:479120, 2013
                                                                                                  4. Younga J et al: Venous hemangioma presenting as a superior sulcus tumor. Ann Thorac Surg. 90(6):2033-5, 2010
                                                                                                  5. Tamura M et al: Current treatment paradigms of superior sulcus tumours. Eur J Cardiothorac Surg. 36(4):747-53, 2009
                                                                                                  6. Davis GA et al: Pancoast tumors. Neurosurg Clin N Am. 19(4):545-57, v-vi, 2008
                                                                                                  7. Davis GA et al: Pancoast tumor resection with preservation of brachial plexus and hand function. Neurosurg Focus. 22(6):E15, 2007
                                                                                                  8. Rusch VW: Management of Pancoast tumours. Lancet Oncol. 7(12):997-1005, 2006
                                                                                                  9. Shah H et al: Brain: the common site of relapse in patients with pancoast or superior sulcus tumors. J Thorac Oncol. 1(9):1020-2, 2006
                                                                                                  10. Archie VC et al: Superior sulcus tumors: a mini-review. Oncologist. 9(5):550-5, 2004
                                                                                                  11. Huehnergarth KV et al: Superior pulmonary sulcus tumor with Pancoast syndrome. Mayo Clin Proc. 79(10):1268, 2004
                                                                                                  12. Weyant MJ et al: Imaging of pleural and chest wall tumors. Thorac Surg Clin. 14(1):15-23, 2004
                                                                                                  13. Beshay M et al: Tuberculosis presenting as Pancoast tumor. Ann Thorac Surg. 76(5):1733-5, 2003
                                                                                                  14. Detterbeck FC et al: Lung cancer. Special treatment issues. Chest. 123(1 Suppl):244S-258S, 2003
                                                                                                  15. Detterbeck FC: Changes in the treatment of Pancoast tumors. Ann Thorac Surg. 75(6):1990-7, 2003
                                                                                                  16. Kichari JR et al: MR imaging of the brachial plexus: current imaging sequences, normal findings, and findings in a spectrum of focal lesions with MR-pathologic correlation. Curr Probl Diagn Radiol. 32(2):88-101, 2003
                                                                                                  17. Dartevelle P et al: Surgical management of superior sulcus tumors. Oncologist. 4(5):398-407, 1999
                                                                                                  18. Ducic Y et al: A logical approach to the thoracic inlet: the Dartevelle approach revisited. Head Neck. 21(8):767-71, 1999
                                                                                                  19. Jones DR et al: Pancoast tumors of the lung. Curr Opin Pulm Med. 4(4):191-7, 1998
                                                                                                  20. Kuhlman JE et al: CT and MR imaging evaluation of chest wall disorders. Radiographics. 14(3):571-95, 1994