Pancoast's Syndrome Secondary to Infectious Etiologies: A Not So Uncommon Occurrence

White, Heath; Boethel, Carl; Arroliga, Alejandro C.; White, Bobbie Ann Adair

doi:10.1097/maj.0b013e3181fa2e2d

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…The earliest report of disease characteristics alluding to Pancoast syndrome was described in 1838 by an English surgeon, Edward Selleck Hare [7] . In 1924, American radiologist Henry K. Pancoast published further reports of this disease, describing three major manifestations that are associated with the disease: severe pain from shoulder to hand, muscular atrophy in the wrist and hand, and ipsilateral Horner syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…In 1924, American radiologist Henry K. Pancoast published further reports of this disease, describing three major manifestations that are associated with the disease: severe pain from shoulder to hand, muscular atrophy in the wrist and hand, and ipsilateral Horner syndrome. Eight years later, Pancoast came out with an additional report of seven patients with Pancoast syndrome, and officially named this disease as superior pulmonary sulcus tumour [7] . The pathology was divided into two categories: (1) tumours in the apex of lung (including primary tumour in apex of lung such as primary lung cancer, cervical spine tumour, laryngeal cancer, Hodgkin's disease, and pleural mesothelioma, among other things), and metastases from sites of origin such as stomach, pancreas, thyroid, breast, oesophagus, etc.…”

Section: Discussionmentioning

confidence: 99%

“…; (2) other non-malignant lesions such as benign tumour and injury, as well as non-specific and specific inflammations, such as tuberculosis, hydatid cysts [8] , etc. The trait of this disease that causes inflammation is being taken seriously by experts [7] ; however, the pathology of primary tumour in apical site still remains dominant [9] . Clinical manifestation: In our patient, apical lesion was evident but he lacked certain lung cancer characteristics such as cough, difficulty to breathe, and hemoptysis [8] , among other things.…”

Section: Discussionmentioning

confidence: 99%

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A case study and literature review of surgical treatment for brachial plexus pain caused by Pancoast syndrome

et al. 2016

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This study reports the diagnosis and treatment of brachial plexus-associated intractable pain caused by Pancoast syndrome, along with the associated literature review, based on a patient we attended to in April 2011. A full examination was performed after his admission, and neurolysis was performed on the right brachial plexus of lower trunk. Follow-ups and treatment evaluations were carried out 1, 2, 3, and 6 months after the initial neurolysis procedure, which was followed by a radiation therapy two months later. The patient's pain symptoms were relieved and he partially regained the sense awareness and movement of his right hand. We found that early clinical manifestations of Pancoast syndrome are atypical and are sometimes difficult to detect. It is very similar to brachial plexus injury-related pain, and the patient must be referred to an orthopaedics or hand surgery specialist for treatment. Therefore, improving medical practitioners' general understanding of this disease is essential in order to avoid potential misdiagnoses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case study and literature review of surgical treatment for brachial plexus pain caused by Pancoast syndrome

et al. 2016

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“…Whereas stroke from rhinocerebral mucormycosis causing occlusion of the cavernous portion of the internal carotid is well documented [4], involvement of the brachial vascular and nervous plexus is a very unusual presentation. Three reports document mucormycosis presenting as a Pancoast syndrome [5-7]. Notably, two had diabetes (both survived) as their only risk factor and one had acute lymphoblastic leukemia (died).…”

Section: Discussionmentioning

confidence: 99%

“…Other causes include metastatic neoplasms and infections. In a recent review of 31 patients with infectious causes of Pancoast syndrome, five were immunocompromised (acute myelogenous leukemia, acute lymphoblastic leukemia, and postchemotherapy), and all had opportunistic organisms ( Aspergillus spp., mucor, nocardia, and Pseudoallescheria boydii ) [7]. In contrast, only one of the 26 immunocompetent patients had an opportunistic organism.…”

Section: Discussionmentioning

confidence: 99%

A rapidly progressing Pancoast syndrome due to pulmonary mucormycosis: a case report

et al. 2011

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IntroductionPancoast syndrome is characterized by Horner syndrome, shoulder pain radiating down the arm, compression of the brachial blood vessels, and, in long-standing cases, atrophy of the arm and hand muscles. It is most commonly associated with lung carcinoma but rarely is seen with certain infections.Case presentationWe present the case of a 51-year-old Caucasian man who had acute myeloid leukemia and who developed a rapidly fulminating pneumonia along with signs and symptoms of acute brachial plexopathy and left Horner syndrome. Also, a purpuric plaque developed over his left chest wall and progressed to skin necrosis. The skin biopsy and bronchoalveolar lavage showed a Rhizopus species, leading to a diagnosis of mucormycosis. This is a rare case of pneumonia due to mucormycosis associated with acute Pancoast syndrome.ConclusionsAccording to our review of the literature, only a few infectious agents have been reported to be associated with Pancoast syndrome. We found only three case reports of mucormycosis associated with acute Pancoast syndrome. Clinicians should consider mucormycosis in their differential diagnosis in a patient with pulmonary lesions and chest wall invasion with or without neurological symptoms, especially in the setting of neutropenia or other immunosuppressed conditions. It is important to recognize this condition early in order to target therapy and interventions.

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Pupillary Disorders

Walsh¹,

Liu²

2012

Encyclopedia of Life Sciences

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Pupillary abnormalities range from benign isolated findings to harbingers of significant, even life‐threatening, conditions. A complete understanding of the neuroanatomy underlying the innervations to the antagonistic pupillary sphincter and dilator muscles is essential to detecting, and discerning the importance of, a particular pupillary abnormality. The sphincter muscle receives neuronal input from the parasympathetic division of the autonomic nervous system, whereas the dilator muscle receives input from the sympathetic division. Afferent input carrying light information to the brain is transmitted by retinal ganglion cell axons via the optic nerves, chiasm, and tracts. The parasympathetic innervation to the pupil originates in the Edinger‐Westphal nucleus in the midbrain. The sympathetic innervation to the pupil consists of a three‐neuron pathway originating in the hypothalamus. Important pupillary disorders include physiologic anisocoria, relative afferent pupillary defect, amaurotic pupil, Argyll Robertson pupils, cranial nerve III palsy, pharmacologic mydriasis, tonic pupil, and Horner syndrome. Key Concepts: Examination of the pupil is an important part of the physician's neurological and ophthalmological evaluation of a patient. The size of the pupil is controlled by the actions of antagonistic muscles located within the iris: the pupillary sphincter and dilator. Constriction of the pupils is mediated by the parasympathetic nervous system, whereas dilation of the pupils is mediated by the sympathetic nervous system. Pupillary constriction to light occurs via an involuntary reflex arc. Retinal ganglion cell axons involved in carrying light information for the pupillary light reflex exit the optic tract (proximal to the lateral geniculate nucleus) to synapse in the midbrain pretectal nucleus. The parasympathetic output controlling pupillary constriction originates in the Edinger‐Westphal nucleus in the midbrain and terminates at the pupil sphincter muscle. Pupillary dilation involves a ‘three‐neuron’ sympathetic pathway, which originates in the posterolateral hypothalamus and terminates at the pupil dilator muscle. A relative afferent pupillary defect is caused by a decreased amount of light information from the affected eye reaching the pretectal nuclei in the midbrain and is most commonly a sign of ipsilateral optic nerve pathology. Damage to cranial nerve III can result in injury to the parasympathetic fibres travelling to the pupillary sphincter muscle, thus disrupting the efferent arc of the pupillary light reflex, resulting in deficient pupillary constriction on the involved side. Horner syndrome, characterised by miosis, ptosis, and facial anhidrosis, results from disruption of the oculosympathetic pathway.

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Pancoast's Syndrome Secondary to Infectious Etiologies: A Not So Uncommon Occurrence

Cited by 17 publications

References 25 publications

A case study and literature review of surgical treatment for brachial plexus pain caused by Pancoast syndrome

A case study and literature review of surgical treatment for brachial plexus pain caused by Pancoast syndrome

A rapidly progressing Pancoast syndrome due to pulmonary mucormycosis: a case report

Pupillary Disorders

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