Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Jan 24;12(1):e227873.
doi: 10.1136/bcr-2018-227873.

Pancoast tumour presenting as shoulder pain with Horner's syndrome

Nimlan Shanmugathas  1 , Kapil Mohan Rajwani  2 , Shumontha Dev  3
Affiliations
Case Reports

Pancoast tumour presenting as shoulder pain with Horner's syndrome

Nimlan Shanmugathas et al. BMJ Case Rep. .

Abstract

A 54-year-old man presented to the emergency department with a 4-week history of right shoulder pain radiating down his arm, with some associated sensory loss. Further questioning and examination in the department revealed a classical Horner's syndrome; miosis, partial ptosis and hemifacial anhidrosis. An initial chest X-ray was deemed to be unremarkable; however, further review by a radiologist noted asymmetrical right apical thickening. A subsequent high-resolution CT scan of the chest revealed a right-sided Pancoast tumour. This case highlights the importance of a thorough history and examination in identifying a rare cause of shoulder and/or back pain.

Keywords: lung cancer (oncology); orthopaedics; rheumatology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Plain chest radiograph with subtle right apical pleural thickening. Circle seen highlights the abnormality on the chest radiograph of the ’apical thickening'.
Figure 2
Figure 2
Coronal contrast-enhanced CT scan showing the 5.1 cm apical mass.
Figure 3
Figure 3
Axial contrast-enhanced CT scan showing the 5.1 cm apical mass.
Figure 4
Figure 4
Positron emission tomography scan highlighting increased uptake in the 5.1 cm apical mass.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kisch B. Horner’s syndrome, an American discovery. Bull Hist Med 1951;25:284–28. - PubMed
    1. Anon. Johann Friedrich Horner, (1831-1886) "a form of ptosis". JAMA 1969;208:1899–900. 10.1001/jama.1969.03160100089019 - DOI - PubMed
    1. Kanagalingam S, Miller NR. Horner syndrome: clinical perspectives. Eye Brain 2015;7:35–46. 10.2147/EB.S63633 - DOI - PMC - PubMed
    1. Smith PG, Dyches TJ, Burde RM. Topographic analysis of Horner’s syndrome. Otolaryngol Head Neck Surg 1986;94:451–7. 10.1177/019459988609400409 - DOI - PubMed
    1. Thompson H, Maxner C, Corbett J. Horner’s syndrome due to damage to the preganglionic neuron of the oculosympathetic pathway Huber A, Symphathetics and the Eye. Stuttgart, Germany: Ferdinand Enke, 1990.

Publication types