Overview
- Carcinoma that occurs in apex of lung
- also known as a superior sulcus tumor
- defined by location
- bronchogenic adenocarcinoma most common histologic type
- historically, squamous cell carcinoma was most common
- Associated conditions
- Horner syndrome
- proximity of the tumor to the superior cervical sympathetic ganglion chain can result in destruction/compression of the chain yielding characteristic
- ptosis
- miosis
- anhidrosis
- proximity of the tumor to the superior cervical sympathetic ganglion chain can result in destruction/compression of the chain yielding characteristic
- thoracic outlet syndrome
- proximity of the tumor to the thoracic outlet of the brachiplexus can result in compression of the C8, T1, and T2 nerve roots yielding characteristic:
- axillary pain
- shoulder pain especially along the cervical border of the scapula
- pain along the ulnar nerve distribution
- proximity of the tumor to the thoracic outlet of the brachiplexus can result in compression of the C8, T1, and T2 nerve roots yielding characteristic:
- Horner syndrome
- fourth and fifth digit pain, numbness, and muscle atrophy
Presentation
- Symptoms
- most common presenting symptom is shoulder pain that radiates to the axilla and scapula
Evaluation
- Imaging
- cancer staging studies
- CT chest, abdomen, and pelvis
- MRI
- cancer staging studies
- PET scan
Treatment
- Determined by type of tumor and extent of disease