A 65-year-old miner has lost 7 kgs weight within two months, has presented with cough, and blood streaked sputum. He was treated for pulmonary tuberculosis 10 years ago. He also has drooping of his left eyelid for one month. On physical examination, there is ptosis of the left eye and papillary miosis. Chest X-ray revealed round opacification in the left upper apical lobe. What is the most probable diagnosis?
Ans. is 'c' i.e. Squamous cell carcinoma The diagnosis is quite straight forward. Significant wt. loss, old age, cough, hemoptysis, Homer's syndrome (ptosis & miosis) and apical opacity on x-ray all suggest the diagnosis of Pancoast tumor. Pancoast tumors are lung cancers that form at the extreme apex of either the right or left lung in the superior sulcus (a shallow furrow in the surface of the lung) thus also k/a superior sulcus tumor. Pancoast tumors are most commonly adenocarcinoma, but also can be squamous cell carcinoma or other histological types.
Secondary tuberculosis
Adenocarcinoma
Squamous cells carcinoma
Asbestosis