A Pancoast tumor, or superior sulcus tumor, is a type of cancerous tumor that forms at the top of the lungs. It can spread to other areas of the body and cause symptoms such as arm pain, unusual sensations, and muscular weakness. A Pancoast tumor is a type of lung cancer that accounts for less than 3–5% of lung tumor cases.

Most Pancoast tumors consist of non-small lung cancer cells, cancerous cells that grow slowly but spread rapidly. Like other forms of cancer, Pancoast tumors can cause cancer to spread around the body.

Initial symptoms of a Pancoast tumor, such as pain, can resemble muscular conditions. As such, people experience a misdiagnosis or a delay in diagnosis. This can affect access to effective treatment.

This article will explain Pancoast tumors, including their symptoms and causes. It will also discuss a Pancoast tumor’s diagnosis, treatment, and outlook.

Pancoast tumors can spread from the top of the lung to the ribs, nerves, and other adjoining body parts. This can cause symptoms in varying areas of the body. For example, common symptoms of Pancoast tumors include chest, shoulder, and arm pain. These symptoms may be the first signs of a Pancoast tumor that you experience.

Shortness of breath is a common symptom of lung cancer. However, early Pancoast tumors may not cause typical lung cancer symptoms due to their unique placement. Breathing symptoms may develop later when the tumor affects more of the lung.

Learn more about early symptoms of lung cancer, including respiratory symptoms.

A Pancoast tumor that spreads and affects specific body structures is Pancoast syndrome. Because a Pancoast tumor must meet specific criteria to be Pancoast syndrome, Pancoast syndrome is less common. Pancoast syndrome specifically causes symptoms such as:

Contact your doctor promptly for any symptoms of a Pancoast tumor.

A Pancoast tumor can indicate one of many different subtypes of cancer. These types of cancerous tumors can include:

Clinicians may use the staging process to determine the extent and spread of the tumor. To do this, many clinicians use the “TNM” classification system to help to assess tumors.

TNM is an abbreviation of the following characteristics of a tumor:

These letters can come with numbers indicating the progression’s severity or extent. For example, the “T” classification can include 4 stages: T1, T2, T3, and T4. T4 is the most severe.

Pancoast tumors often develop into the chest wall and other areas, causing a significant spread. As such, they tend to have a T3 or T4 status. 

As with other cancers, Pancoast tumors develop when cells in the body grow uncontrollably and affect other body tissues. This can occur spontaneously or as a result of certain triggers, such as smoking.

The following factors may increase a person’s risk of developing the condition:

Clinicians also believe Pancoast syndrome can result from other medical conditions, such as: 

Your doctor will begin the diagnostic process by asking about your symptoms and performing a physical exam.

They may also order further tests, such as:

Pain symptoms can occur due to other conditions. Therefore, some people with a Pancoast tumor experience misdiagnosis or a delay in relevant treatment.

Contact your doctor for further review of your test results if pain does not improve following your initial treatment. Inform your doctor of your medical history, including any history of exposure to smoke, chemicals, or infection.

Treatment for Pancoast tumors depends on how much the tumors have spread.

Some treatment options can include:

Your doctor may combine these treatment methods instead of applying just one.

They may also recommend pain relief medication for the pain and steroids for the nerve pressure. Additional management options are available to alleviate other symptoms.

Without effective treatment, Pancoast tumors can lead to serious complications, such as:

The outlook for people with Pancoast tumors can be poor, especially if they have experienced a delayed or incorrect diagnosis. In these cases, clinicians may only identify Pancoast tumors once the cancer has spread.

By contrast, the outlook can be positive for those who received diagnosis and treatment at an early stage of the condition.

Contact your doctor or medical team for more information about your outlook and what you can expect from treatment.

Adithya Cattamanchi, M.D., has reviewed the following frequently asked questions.

Both pinched nerves and Pancoast tumors can cause symptoms such as pain and muscle weakness.

Doctors can differentiate and diagnose the conditions by ordering further diagnostic tests, such as imaging scans. A Pancoast tumor may also cause additional symptoms, such as Horner’s syndrome, fatigue, and weight loss.

Contact your doctor if your symptoms persist or do not improve with treatment for other causes of pain.

Some people have reported that their pain or discomfort from a Pancoast tumor worsens at night or while resting. However, limited clinical research explains how or why this may occur.

Contact your doctor for further advice if you experience pain that worsens or does not improve with management and treatment.

A Pancoast tumor is a type of cancerous tumor that forms at the top of the lungs. It can spread to nearby body parts, such as the chest and nerves. Due to this, symptoms can involve many bodily systems. Examples of early symptoms include shoulder and arm pain, loss or weakness of the arm muscles, and Horner’s syndrome.

These symptoms can occur due to other conditions. As such, some people and doctors may not be aware that a tumor is the underlying cause. This can delay treatment.

As a result, it is important to contact your doctor for any symptoms of pain that do not improve with initial treatment. Additionally, seek prompt treatment if you have symptoms of a Pancoast tumor or difficulty breathing.

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