Vargo M M, Flood K M
Division of Rehabilitation Medicine, Hospitals of the University Health Center, Pittsburgh, PA.
Arch Phys Med Rehabil. 1990 Jul;71(8):606-9.
A case of Pancoast tumor presenting as cervical radiculopathy is reported, including the clinical, EMG, and radiologic findings. A 64-year-old man with a two-month history of left shoulder pain and left arm numbness at the medial aspect of the hand and forearm presented for electrodiagnostic examination, and a severe C8 radiculopathy was documented. Subsequent radiologic evaluation (myelogram and routine chest x-ray) yielded the diagnosis of left apical lung tumor (Pancoast tumor), eroding through the C7 and T1 pedicles and T1 vertebral body, with cut-off of the left C8 nerve root. Pancoast tumor has long been implicated as a cause of brachial plexopathy. The EMG presentation of isolated cervical radiculopathy, however, has not been previously reported, despite the tumor's known tendency for local invasion which may include the nerve roots and even the spinal canal in its advanced stages. This patient's normal sensory studies argue against any significant coexisting lower brachial plexopathy. The possibility of Pancoast lesion should be considered not only in the presence of brachial plexopathy, but also when C8 or T1 radiculopathy is found.
报告了一例表现为颈神经根病的潘科斯特瘤病例，包括临床、肌电图和放射学检查结果。一名64岁男性，有两个月的左肩疼痛及左手和前臂内侧麻木病史，前来接受电诊断检查，确诊为严重的C8神经根病。随后的放射学评估（脊髓造影和常规胸部X光）诊断为左肺尖肿瘤（潘科斯特瘤），该肿瘤侵蚀了C7和T1椎弓根以及T1椎体，并切断了左侧C8神经根。长期以来，潘科斯特瘤一直被认为是臂丛神经病变的一个病因。然而，尽管已知该肿瘤有局部侵袭倾向，在晚期可能累及神经根甚至椎管，但此前尚未有孤立性颈神经根病的肌电图表现的报道。该患者感觉检查正常，排除了任何明显并存的下臂丛神经病变。不仅在出现臂丛神经病变时，而且在发现C8或T1神经根病时，都应考虑潘科斯特病变的可能性。
