Cancer, Lung Pancoast (Superior Sulcus Tumor)

Pancoast or superior sulcus tumor consists of a wide range of tumors invading the apical chest wall and producing a characteristic syndrome named "Pancoast -Tobias syndrome." The superior sulcus is an anatomical pleuro-pulmonary groove that is formed by the subclavian artery when it curves in front of the pleura and runs upward and lateral immediately below the apex.[1] Not all superior sulcus tumors are in this exact location, but this term signifies any tumor that presents in the apices of the lungs associated with clinical signs and symptoms that are the hallmark of Pancoast syndrome. The combination of severe shoulder/arm pain along with the distribution of the C8, T1, T2 nerve trunks, Horner syndrome (ipsilateral ptosis, miosis, and anhidrosis; caused due to interruption of sympathetic nerve chain running to the head) and atrophy of the intrinsic hand muscles is termed "Pancoast-Tobias syndrome."[2] The overall prognosis of patients with this disease is poor, although recent advancements in the treatment regimen showed significant improvement. Treatment of Pancoast tumors involves interprofessional care coordinated among a thoracic surgeon, a radiation oncologist, and a medical oncologist.[2]