Pancoast Syndrome

Pancoast syndrome, also known as Horner-Schiffan syndrome, is a rare disease that is characterized by severe pain, paralysis of the shoulder joint and can lead to death. This condition results from damage to the brachial nerve, which provides function to the muscles associated with the shoulder, elbows, and wrist, as well as the nerves that control the mobility and coordination of these muscles.

Typically, Pancoast syndrome is the result of a malignant tumor, such as a metastasis or new tumor, that has appeared on the lung (apex). Such a tumor can put pressure on the nerve structures, causing disturbances in the motor activity of the shoulder region.

Patients with Pancoast syndrome experience intense shoulder and hip pain that often spreads to the arms, fingers, and neck. The pain may increase with movement and pressure on the affected area. Various symptoms may also occur, including weakness of the limb, discoloration and swelling of the arm or leg, difficulty raising the arm above shoulder level, numbness and loss of sensation in certain areas, and even shoulder deformity. If left untreated, Pancoast syndrome can become life-threatening as it can cause muscle atrophy and complete loss of limb function.

Pancoast Syndrome is a condition characterized by pain and paralysis caused by damage to the brachial plexus due to infiltration of a malignant tumor developing in the apex of the lung. This syndrome is often observed in patients suffering from Horner's syndrome.

Pancoast syndrome got its name in honor of the American pathologist Henry Pancoast, who first described this clinical entity in 1924. He noted that tumors developing in the apex of the lung can put pressure on the brachial plexus, the nerve structure responsible for innervation of the upper limb. As a result of this pressure, patients may experience intense pain in the shoulder, shoulder blade and arm, as well as partial or complete paralysis of the corresponding muscles.

Pancoast syndrome usually develops against the background of malignant tumors such as lung cancer, especially in the upper part of the lung. The tumor can infiltrate surrounding tissues, including the brachial plexus, which leads to compression of the nerve structures and the appearance of symptoms of the syndrome.

One of the common accompanying symptoms of Pancoast syndrome is Horner's syndrome. Horner's syndrome is characterized by symptoms such as ptosis (drooping of the upper eyelid), miosis (constriction of the pupil), anhidrosis (lack of sweating) and hemifacial angiodystonia (dilation of facial capillaries). This syndrome occurs due to damage to the sympathetic innervation of the face and eye.

Diagnosis of Pancoast syndrome involves the patient's medical history, physical examination including neurological and ophthalmological examination, and various imaging studies such as radiography, computed tomography (CT) and magnetic resonance imaging (MRI). A tumor biopsy may be necessary to confirm the diagnosis and determine the type of tumor.

Treatment of Pancoast syndrome depends on the underlying disease leading to the development of the syndrome. This may include surgical removal of the tumor, radiation and chemotherapy, and the use of medications to relieve pain and improve the patient's quality of life.

In conclusion, Pancoast syndrome is a condition caused by damage to the brachial plexus due to infiltration of a malignant tumor in the apex of the lung. It is often accompanied by Horner's syndrome and manifests itself through pain and paralysis in the shoulder, scapula and arm. Diagnosis includes medical history, physical examination and various instrumental studies. Treatment depends on the underlying disease and may include surgery, radiation and chemotherapy, as well as pain relief and improving the patient's quality of life with medications.

Pancoast syndrome is a serious medical condition that requires prompt diagnosis and treatment. Therefore, it is important to see a doctor if you experience characteristic symptoms such as pain in the shoulder, scapula or arm, paralysis of a limb, as well as accompanying symptoms of Horner's syndrome. Early detection and treatment will improve the patient's prognosis and quality of life.