Bronchogenic carcinoma in the thoracic inlet prior to obvious signs and symptoms of Pancoast's syndrome is difficult to recognize, and should be considered more frequently as a cause of pain in the shoulder and arm. This study of four cases illustrates this fact. Abnormal physical findings are late manifestations of the lesion. Interpretation of conventional thoracic roentgenograms may be misleading unless apical regions are carefully compared. The clinician should beware of roentgenologic findings interpreted as thickened apical pleura. Recent reports indicate possible cures of this tumor following a combination of radiation therapy and resection. In view of such reports, early recognition of bronchogenic carcinoma in the thoracic inlet is of greater importance than ever.
Hughes RK, Katz RI. Late Recognition of Bronchogenic Carcinoma in the Thoracic Inlet. JAMA. 1965;192(11):964–966. doi:10.1001/jama.1965.03080240034007
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