Schwannoma and Paraganglioma: Rare Causes of Pancoast Tumors With Increased FDG Uptake on Pet/Ct

Abstract

Pancoast tumors are the masses that are located at the apical region of the lungs and may cause some typical symptoms, named as Pancoast Syndrome, like shoulder and arm pain, Horner's syndrome (ipsilateral ptosis, myosis, enophthalmus and anhydrosis) and weakness in ipsilateral hand musculature due to the invasion of the adjacent nerves and bone. These tumors are commonly the malign lung carcinomas. Here we report two cases of patients suffering from back and arm pain and that have some pancoast syndrome symptoms mentioned above, related to apical mass in radiological images. One of these patients had ptosis and anhydrosis associated with Horner's syndrome. 2-Deoxy-2-[18F] Fluoro-D-Glucose (FDG) with positron emission tomography/computerized tomography (PET/CT)was performed because of a suspicion of malignancy and an intense FDG accumulation was seen coincident with the apical tumor in both. The patients then underwent complete surgical resection of the mass and the masses were postoperatively diagnosed as paraganglioma and schwannoma, respectively. So, we wanted to emphasize that neurogenic tumors should be included in the differential diagnosis of Pancoast tumor as a rare cause and to remind the clinicians to give their attentions for essentiality of tissue diagnosis of Pancoast carcinoma before starting the treatment.