“Superior Pulmonary Sulcus Tumors”
1946; Radiological Society of North America; Volume: 47; Issue: 2 Linguagem: Inglês
10.1148/47.2.188
ISSN1527-1315
Autores Tópico(s)Bone Tumor Diagnosis and Treatments
ResumoHomeRadiologyVol. 47, No. 2 PreviousNext “Superior Pulmonary Sulcus Tumors”Published Online:Aug 1 1946https://doi.org/10.1148/47.2.188MoreSectionsPDF ToolsAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookXLinked In AbstractIn 1924, Pancoast (4) described a syndrome the outstanding features of which were an apical lung tumor, demonstrable roentgenographically, referred nerve phenomena in the upper extremity on the involved side, and cervical sympathetic paralysis suggesting a spinal cord tumor, cervical rib, or vertebral neoplasm. Four cases were included in Pancoast's original report and a pleural origin was assigned to the tumors, though he believed that a similar chain of symptoms might accompany other new growths. According to Moersch, Hinshaw, and Wilson (3) this same group of findings had been described in 1838 by Hare, in a contribution in the London Medical Gazette, but little attention had been paid to that early report.In 1932, Pancoast (5) again discussed the subject, before the American Medical Association, adding four cases to his original series. He now discarded a pleural origin for these tumors and suggested that they might arise from an embryonal epithelial rest. He believed that they could not be regarded as primary lung cancers and suggested the name “superior pulmonary sulcus tumor” to designate what he regarded as a distinct pathologic entity. Symptoms included pain around the shoulder, extending down the inner side of the arm, loss of power and wasting of the muscles of the hand, and Horner's syndrome. The roentgenogram disclosed a comparatively small circumscribed shadow at the pulmonary apex, together with destruction of portions of one or more ribs and the adjacent lateral processes or bodies of one or more vertebrae.Pancoast considered Horner's syndrome an essential feature in the diagnosis of the new tumor and did not admit to the group apical conditions manifesting only part of the symptom complex. On the other hand, he felt that the condition might be overlooked because of incomplete roentgeno-graphic studies, especially in cases in which pain in the shoulder was the dominant complaint.More than two decades have passed since Pancoast's earlier report, and nearly a decade and a half since his suggestion that superior pulmonary sulcus tumors constitute a separate pathological entity. In the intervening years many observers have recorded their findings in similar cases, with a consequent clarification of the subject. Jacox (2) in 1934 reported two cases. In one of these, postmortem examination established a diagnosis of primary carcinoma of the pulmonary apex arising from the mucosa of the bronchioles in that area. In the other, no pathologic studies were made but the clinical course was similar.In 1936, Steiner and Francis (6) recorded three cases, with postmortem confirmation in two and biopsy examination in the third. They believed that their tumors originated in the lung. Clinically they were said to represent a generally unrecognized type of cancer, but the microscopic findings corresponded to types of growth commonly observed in primary pulmonary neoplasms.Article HistoryPublished in print: Aug 1946 FiguresReferencesRelatedDetailsCited ByHandbuch der Medizinischen Radiologie / Encyclopedia of Medical RadiologyV.Schneider1978 | , Vol. 9 / 5 / aRADIATION MANAGEMENT OF APICAL LUNG TUMORSLewis L.Haas, Roger A.Harvey, Charles F.Melchor1957 | Journal of Thoracic Surgery, Vol. 33, No. 4Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 47, No. 2 Metrics Altmetric Score PDF download
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