Bonet G, Ribas J, Ruiz J, Salavert A, Bechini J, Morera J
Servicios de Neumología, Hospital Universitario Germans Trias y Pujol, Badalona, Barcelona.
Arch Bronconeumol. 1998 Jun;34(6):307-9. doi: 10.1016/s0300-2896(15)30418-x.
Pancoast's syndrome is characterized by pain in the shoulders and upper extremities, Horner's syndrome, bone loss and hand muscle atrophy. Bronchogenic carcinoma is the most common cause, although other neoplasms or lung infection are occasionally responsible. An apical mass on the chest film can be seen in over 90% of cases, although apical pleural thickening is sometimes the only radiographic finding. We describe a patient whose clinical picture was highly suggestive of Pancoast's syndrome but whose chest film was normal. Magnetic resonance imaging disclosed a cervical mass adjacent to the brachial plexus that proved to be cervical metastasis from an unknown primary tumor. We emphasize the need to consider the possibility of a metastatic cervical tumor compromising the brachial plexus in patients with a normal chest X-ray but clinical signs highly suggestive of Pancoast's syndrome.
潘科斯特综合征的特征为肩部和上肢疼痛、霍纳综合征、骨质流失和手部肌肉萎缩。虽然其他肿瘤或肺部感染偶尔也可导致，但支气管源性癌是最常见的病因。超过90%的病例在胸部X线片上可见肺尖肿块，不过有时肺尖胸膜增厚是唯一的影像学表现。我们报告1例临床症状高度提示潘科斯特综合征但胸部X线片正常的患者。磁共振成像显示臂丛神经旁有一颈部肿块，结果证实是来自未知原发肿瘤的颈部转移瘤。我们强调，对于胸部X线片正常但临床症状高度提示潘科斯特综合征的患者，需要考虑转移性颈部肿瘤累及臂丛神经的可能性。
