Pancoast syndrome
Introduction
Introduction to Pancoast Syndrome Pancoast syndrome (Pancoastsyndrome), also known as apical tumor syndrome, refers to a group of symptoms of upper limb refractory pain and ipsilateral Horner syndrome caused by tumor infiltration and compression of the apex of the lung. The intrinsic is firstly performed by Pancoast (1924). )put forward. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: neck and shoulder pain
Cause
The cause of Pancoast syndrome
(1) Causes of the disease
Common causes are lung cancer, pleural mesothelioma, breast cancer, thyroid cancer, esophageal cancer, etc., the most common lung cancer, especially lung cancer or lung sulcus cancer, sometimes metastatic cancer of the lung tip.
(two) pathogenesis
The tumor invades the bone and causes the symptoms through the nerve plexus at the entrance of the chest. If the first and second ribs are destroyed, there may be local pain; when the brachial plexus is involved, there may be upper limb sensation or movement disorder; the sympathetic chain is involved, which may cause Horner syndrome.
Prevention
Pancoast Syndrome Prevention
Prevention: Active treatment of primary disease, while strengthening nutrition and supportive therapy.
Complication
Pancoast syndrome complications Complications neck and shoulder pain
Can cause Horner syndrome both tumor invasion of the bone and the nerve plexus through the chest entrance caused by symptoms, if the first and second ribs are destroyed, there may be local pain; when the brachial plexus is involved, there may be upper limb sensation or movement disorder; sympathetic chain Being involved can cause Horner syndrome. Due to any compression and destruction on the pathway from the sympathetic nerve to the eye, the pupil is reduced, the eyeball is invaginated, the ptosis is drooping, and there is no sweat syndrome on the lateral side.
Symptom
Symptoms of Pancoast Syndrome Common Symptoms Sustained severe shoulder pain, axillary pain, pupillary deformity, eyeball retraction, eyelid ptosis, upper limb numbness
Patients with lung cancer or mediastinal tumors have persistent severe shoulder pain, axillary pain and upper limb pain. At the same time, there may be Horner syndrome such as ptosis of the affected eyelid, depression of the eyeball, reduction of the pupil, and lack of sweat and paresthesia on the lateral side.
Examine
Pancoast syndrome check
Chest X-ray examination: no abnormalities in the early stage, or only the blurred shadow of the tip of the lung. When the mass is gradually enlarged, there may be a blocky shadow protruding from the lung. 1 to 3 ribs are often eroded and eroded, and the nearby vertebrae can also be damage.
Diagnosis
Diagnostic identification of Pancoast syndrome
According to clinical manifestations, chest X-ray examination can initially make a diagnosis.
It should be differentiated from central nervous system disorders and brain stem injuries.
