Pancoast tumor physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pancoast tumor}} | {{Pancoast tumor}} | ||
{{CMG}}{{AE}}{{Mazia}} | {{CMG}}; {{AE}} {{Mazia}} | ||
==Overveiw== | ==Overveiw== | ||
Common [[physical examination]] findings of Pancoast tumor include decreased/absent [[breath sounds]], [[pallor]], [[low-grade fever]], and [[tachypnea]]. On [[physical examination]], Pancoast tumor may present with features of [[lethargy]], [[emaciation]], [[confusion]], [[Low-grade fever|low-grade]] [[fever]], decreased sPO<sub>2</sub>, [[tachypnea]], [[tachycardia]], low [[blood pressure]], decreased/absent [[breath sounds]], [[bone]] [[pain]], [[fractures]] (usually in the [[vertebrae]], [[femur]], [[pelvic bones]], and the [[ribs]]), [[pallor]], decreased [[sweating]] on [[ipsilateral]] side of the [[face]], [[ptosis]], [[miosis]], anhydrosis, [[supraclavicular]] [[lymphadenopathy]], [[cranial nerve palsies]], [[tingling]] and [[pain]] along the [[Ulnar nerve|distribution of ulnar nerve]], [[clubbing]] of [[fingers]], [[weakness]] of [[Arm|arms]] and [[hands]], [[hemiplegia]], [[paraplegia]], [[shoulder pain]], [[Edema|edematous]] [[swelling]] of the [[ipsilateral]] [[arm]]. | |||
==Physical Examination== | ==Physical Examination== | ||
Pancoast tumor is a subtype of lung cancer localized to the apical portion of the lung. Common physical examination findings of Pancoast tumor include decreased/absent [[breath sounds]], [[pallor]], low-grade [[fever]], and [[tachypnea]].<ref name="DegnerSloan1995">{{cite journal|last1=Degner|first1=Lesley F.|last2=Sloan|first2=Jeffrey A.|title=Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer|journal=Journal of Pain and Symptom Management|volume=10|issue=6|year=1995|pages=423–431|issn=08853924|doi=10.1016/0885-3924(95)00056-5}}</ref><ref name="pmid2299974">{{cite journal |vauthors=Feinstein AR, Wells CK |title=A clinical-severity staging system for patients with lung cancer |journal=Medicine (Baltimore) |volume=69 |issue=1 |pages=1–33 |year=1990 |pmid=2299974 |doi= |url=}}</ref><ref name="pmid2992757">{{cite journal |vauthors=Chute CG, Greenberg ER, Baron J, Korson R, Baker J, Yates J |title=Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont |journal=Cancer |volume=56 |issue=8 |pages=2107–11 |year=1985 |pmid=2992757 |doi= |url=}}</ref><ref name="pmid9266882">{{cite journal |vauthors=Hirshberg B, Biran I, Glazer M, Kramer MR |title=Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital |journal=Chest |volume=112 |issue=2 |pages=440–4 |year=1997 |pmid=9266882 |doi= |url=}}</ref><ref name="pmid10669674">{{cite journal |vauthors=Kuo CW, Chen YM, Chao JY, Tsai CM, Perng RP |title=Non-small cell lung cancer in very young and very old patients |journal=Chest |volume=117 |issue=2 |pages=354–7 |year=2000 |pmid=10669674 |doi= |url=}}</ref><ref name="pmid21276318">{{cite journal |vauthors=Lepper PM, Ott SR, Hoppe H, Schumann C, Stammberger U, Bugalho A, Frese S, Schmücking M, Blumstein NM, Diehm N, Bals R, Hamacher J |title=Superior vena cava syndrome in thoracic malignancies |journal=Respir Care |volume=56 |issue=5 |pages=653–66 |year=2011 |pmid=21276318 |doi=10.4187/respcare.00947 |url=}}</ref><ref name="Buccheri2004">{{cite journal|last1=Buccheri|first1=G.|title=Lung cancer: clinical presentation and specialist referral time|journal=European Respiratory Journal|volume=24|issue=6|year=2004|pages=898–904|issn=0903-1936|doi=10.1183/09031936.04.00113603}}</ref> | Pancoast tumor is a subtype of [[lung cancer]] localized to the [[apical]] portion of the [[lung]]. Common [[physical examination]] findings of Pancoast tumor include decreased/absent [[breath sounds]], [[pallor]], low-grade [[fever]], and [[tachypnea]]. On Physical examination pancoast tumor may present with the features including: <ref name="DegnerSloan1995">{{cite journal|last1=Degner|first1=Lesley F.|last2=Sloan|first2=Jeffrey A.|title=Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer|journal=Journal of Pain and Symptom Management|volume=10|issue=6|year=1995|pages=423–431|issn=08853924|doi=10.1016/0885-3924(95)00056-5}}</ref><ref name="pmid2299974">{{cite journal |vauthors=Feinstein AR, Wells CK |title=A clinical-severity staging system for patients with lung cancer |journal=Medicine (Baltimore) |volume=69 |issue=1 |pages=1–33 |year=1990 |pmid=2299974 |doi= |url=}}</ref><ref name="pmid2992757">{{cite journal |vauthors=Chute CG, Greenberg ER, Baron J, Korson R, Baker J, Yates J |title=Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont |journal=Cancer |volume=56 |issue=8 |pages=2107–11 |year=1985 |pmid=2992757 |doi= |url=}}</ref><ref name="pmid9266882">{{cite journal |vauthors=Hirshberg B, Biran I, Glazer M, Kramer MR |title=Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital |journal=Chest |volume=112 |issue=2 |pages=440–4 |year=1997 |pmid=9266882 |doi= |url=}}</ref><ref name="pmid10669674">{{cite journal |vauthors=Kuo CW, Chen YM, Chao JY, Tsai CM, Perng RP |title=Non-small cell lung cancer in very young and very old patients |journal=Chest |volume=117 |issue=2 |pages=354–7 |year=2000 |pmid=10669674 |doi= |url=}}</ref><ref name="pmid21276318">{{cite journal |vauthors=Lepper PM, Ott SR, Hoppe H, Schumann C, Stammberger U, Bugalho A, Frese S, Schmücking M, Blumstein NM, Diehm N, Bals R, Hamacher J |title=Superior vena cava syndrome in thoracic malignancies |journal=Respir Care |volume=56 |issue=5 |pages=653–66 |year=2011 |pmid=21276318 |doi=10.4187/respcare.00947 |url=}}</ref><ref name="Buccheri2004">{{cite journal|last1=Buccheri|first1=G.|title=Lung cancer: clinical presentation and specialist referral time|journal=European Respiratory Journal|volume=24|issue=6|year=2004|pages=898–904|issn=0903-1936|doi=10.1183/09031936.04.00113603}}</ref> | ||
===General appearance=== | ===General appearance=== | ||
Patients with Pancoast tumor generally appear [[lethargic]], [[Emaciation|emaciated]], and [[Confusion|confused]]. | |||
===Vital Signs=== | ===Vital Signs=== | ||
* Vital signs are generally within normal limit, but patients with severe disease may present the following vital signs: | * Vital signs are generally within normal limit, but [[patients]] with severe [[disease]] may present the following [[vital signs]]: | ||
:* Low-grade [[fever]] | :* [[Low-grade fever|Low-grade]] [[fever]] | ||
:* Decreased | :* Decreased sPO<sub>2</sub> | ||
:* [[Tachypnea]] | :* [[Tachypnea]] | ||
:* [[Tachycardia]] | :* [[Tachycardia]] | ||
:* Low | :* Low [[blood pressure]] | ||
===Chest=== | ===Chest=== | ||
*Decreased/absent [[breath sounds]] | *Decreased/absent [[breath sounds]] | ||
===Skeletal=== | ===Skeletal=== | ||
*Bone pain | *[[Bone pain]] | ||
*Fractures (usually in the vertebrae, femur, pelvic bones, and the ribs) | *[[Fractures]] (usually in the [[vertebrae]], [[femur]], [[pelvic bones]], and the [[ribs]]) | ||
===Skin=== | ===Skin=== | ||
*[[Pallor]] | *[[Pallor]] | ||
*[[ | *Decreased [[sweating]] on [[ipsilateral]] side of the [[face]] | ||
===HEENT=== | ===HEENT=== | ||
*Ptosis | *[[Ptosis]] | ||
*Miosis | *[[Miosis]] | ||
*Anhydrosis | *Anhydrosis | ||
*[[ | *[[Supraclavicular]] [[Lymphadenopathy]] | ||
===CNS=== | ===CNS=== | ||
*Cranial nerve palsies | *[[Cranial nerve palsies]] | ||
*[[Tingling]] and [[pain]] along the [[Ulnar nerve|distribution of ulnar nerve]] | |||
===Extremities=== | ===Extremities=== | ||
*[[Clubbing]] of fingers | *[[Clubbing]] of [[fingers]] | ||
*[[Weakness]] of arms and hands | *[[Weakness]] of [[Arm|arms]] and [[hands]] | ||
*[[Hemiplegia]] | *[[Hemiplegia]] | ||
*[[Paraplegia]] | *[[Paraplegia]] | ||
*Shoulder pain | *[[Shoulder pain]] | ||
*[[Edema|Edematous]] [[swelling]] of the [[ipsilateral]] [[arm]] | |||
==References== | ==References== | ||
Latest revision as of 13:52, 16 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overveiw
Common physical examination findings of Pancoast tumor include decreased/absent breath sounds, pallor, low-grade fever, and tachypnea. On physical examination, Pancoast tumor may present with features of lethargy, emaciation, confusion, low-grade fever, decreased sPO2, tachypnea, tachycardia, low blood pressure, decreased/absent breath sounds, bone pain, fractures (usually in the vertebrae, femur, pelvic bones, and the ribs), pallor, decreased sweating on ipsilateral side of the face, ptosis, miosis, anhydrosis, supraclavicular lymphadenopathy, cranial nerve palsies, tingling and pain along the distribution of ulnar nerve, clubbing of fingers, weakness of arms and hands, hemiplegia, paraplegia, shoulder pain, edematous swelling of the ipsilateral arm.
Physical Examination
Pancoast tumor is a subtype of lung cancer localized to the apical portion of the lung. Common physical examination findings of Pancoast tumor include decreased/absent breath sounds, pallor, low-grade fever, and tachypnea. On Physical examination pancoast tumor may present with the features including: [1][2][3][4][5][6][7]
General appearance
Patients with Pancoast tumor generally appear lethargic, emaciated, and confused.
Vital Signs
- Vital signs are generally within normal limit, but patients with severe disease may present the following vital signs:
- Low-grade fever
- Decreased sPO2
- Tachypnea
- Tachycardia
- Low blood pressure
Chest
- Decreased/absent breath sounds
Skeletal
Skin
- Pallor
- Decreased sweating on ipsilateral side of the face
HEENT
- Ptosis
- Miosis
- Anhydrosis
- Supraclavicular Lymphadenopathy
CNS
- Cranial nerve palsies
- Tingling and pain along the distribution of ulnar nerve
Extremities
- Clubbing of fingers
- Weakness of arms and hands
- Hemiplegia
- Paraplegia
- Shoulder pain
- Edematous swelling of the ipsilateral arm
References
- ↑ Degner, Lesley F.; Sloan, Jeffrey A. (1995). "Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer". Journal of Pain and Symptom Management. 10 (6): 423–431. doi:10.1016/0885-3924(95)00056-5. ISSN 0885-3924.
- ↑ Feinstein AR, Wells CK (1990). "A clinical-severity staging system for patients with lung cancer". Medicine (Baltimore). 69 (1): 1–33. PMID 2299974.
- ↑ Chute CG, Greenberg ER, Baron J, Korson R, Baker J, Yates J (1985). "Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont". Cancer. 56 (8): 2107–11. PMID 2992757.
- ↑ Hirshberg B, Biran I, Glazer M, Kramer MR (1997). "Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital". Chest. 112 (2): 440–4. PMID 9266882.
- ↑ Kuo CW, Chen YM, Chao JY, Tsai CM, Perng RP (2000). "Non-small cell lung cancer in very young and very old patients". Chest. 117 (2): 354–7. PMID 10669674.
- ↑ Lepper PM, Ott SR, Hoppe H, Schumann C, Stammberger U, Bugalho A, Frese S, Schmücking M, Blumstein NM, Diehm N, Bals R, Hamacher J (2011). "Superior vena cava syndrome in thoracic malignancies". Respir Care. 56 (5): 653–66. doi:10.4187/respcare.00947. PMID 21276318.
- ↑ Buccheri, G. (2004). "Lung cancer: clinical presentation and specialist referral time". European Respiratory Journal. 24 (6): 898–904. doi:10.1183/09031936.04.00113603. ISSN 0903-1936.