Surgery>>>>>Chest Wall, Pleura, and Mediastinum
Question 11#

Pancoast tumors are identified as involving all of the following EXCEPT:

A. The chest wall at or below the second rib
B. Tumors of the parietal pleura or deeper structures overlying the first rib
C. The superior sulcus
D. The extreme apex of the chest

Correct Answer is A

Comment:

Carcinoma arising in the extreme apex of the chest with associated arm and shoulder pain, atrophy of the muscles of the hand, and Horner syndrome presents a unique challenge to the surgeon. Any tumor of the superior sulcus, including tumors without evidence for involvement of the neurovascular bundle, is now commonly known as Pancoast tumors, after Henry Pancoast who described the syndrome in 1932. The designation is reserved for tumors involving the parietal pleura or deeper structures overlying the first rib. Chest wall involvement at or below the second rib is not a Pancoast tumor. Treatment is multidisciplinary; due to the location of the tumor and involvement of the neurovascular bundle that supplies the ipsilateral extremity, preserving postoperative function of the extremity is critical.