38 patients with Pancoast syndrome produced by neoplasia are retrospectively reviewed. Analyses are made of the initial symptom (pain in 89.4%), the time until a diagnosis was reached (an average of 5 1/2 months) and these patients' clinical manifestations: pain (97%), neurological manifestations, basically the Bernard-Horner syndrome (50%) and muscle weakness of the upper portion (47%). Analyses are also made of thorax X-rays, which show pulmonary mass (87%), bone destruction (58%), apical unilateral pleural thickening (27%) or bilateral (18%), with one normal case (3%). Frequently (73%) the patients are first seen by rheumatologists or neurologists. Emphasis is given to the importance of knowing the symptomatology for making early diagnosis and to the necessity of doing the necessary examinations, including biopsies, in order to discover the presence of a neoformation when symptomatology of the syndrome exists, even though the thorax X-ray should only show pleural thickening or even be normal. To make a histological diagnosis the two most reliable procedures have been surgical biopsy of the adenopathy or supraclavicular mass (27%) or supraclavicular biopsy with a needle (tru-cut) (24%). The histology of the tumors was epidermoid carcinoma in 20 cases, undifferentiated carcinoma in 7 cases, adenocarcinoma in 5 and sarcoma in one case. The illness was very advanced in the other 5 cases, and no examinations were done to make a histological diagnosis.
|Journal||Revista Espanola de Reumatologia|
|Publication status||Published - 1 Jan 1980|