Pancoast Tumors and Combined Spinal Resections
Pancoast tumors, properly known as superior sulcus carcinomas, are a particularly challenging form of non-small cell lung cancer (NSCLC) to treat surgically because they commonly invade vital structures within and near the thoracic inlet. Invasion of the brachial plexus, subclavian vessels, and spine by direct tumor extension necessitates careful preoperative planning by surgeons and anesthesiologists. Originally described in 1924 (Pancoast HK, J Am Med Assoc 83:1407–11, 1924) and again in 1932, (Pancoast HK, J Am Med Assoc 99:1391-6, 1932) by Henry K. Pancoast, a radiologist at the University of Pennsylvania, this subset of NSCLC was considered inoperable, and thus fatal, for nearly two decades until the late 1950s when the combination of radiotherapy and surgery offered some curative hope. Pancoast’s description of an apical chest tumor associated with shoulder and arm pain, a Horner’s syndrome, and atrophy of the hand muscles describes the constellation of signs and symptoms of the syndrome that has come to bear his name.
KeywordsPancoast tumor resection Superior sulcus tumor resection Combined spinal procedures Preoperative planning Pancoast tumor Surgical approach Pancoast tumor
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