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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.

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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

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