A Unique Case of Pancoast Tumor

Abstract

Background: Pancoast tumors are uncommon malignancies located in the superior sulcus of the lung, characterized by distinctive neurological and vascular involvement. However, extensive venous thrombosis and contralateral nodal involvement are rarely described.
Case Presentation: We report a striking case in a 64-year-old male smoker who presented with chest pain, facial swelling, dyspnea, and right-sided Horner’s syndrome. Imaging revealed a right apical mass invading the thoracic inlet with bilateral internal jugular vein thrombosis and contralateral supraclavicular lymphadenopathy. Histology showed acinar adenocarcinoma.
Management and Outcome: Given extensive locoregional and systemic involvement, curative resection was not feasible, and palliative systemic therapy was initiated.
Conclusion: This rare constellation of findings underscores the aggressive biological behavior of superior sulcus tumors and emphasizes the need for heightened clinical suspicion and early multidisciplinary evaluation.