Primary Carcinoma of the Lung Occurring in the Apex: Report of One Case

Abstract

In recent years neoplasms located in the extreme apex of the chest have been a subject of some controversy. Attention was first called to tumors occurring in this location, in 1924, by Pancoast, who described a group of symptoms and signs which he thought pathognomonic of a new pathological entity, for which he suggested the name “superior pulmonary sulcus tumor.” Since then a number of investigators have had opportunity to study these tumors histologically, as the result of biopsy or necropsy, and cases have been reported that conform in every respect to the syndrome described by Pancoast. The general conclusion has been, however, that these tumors probably belong to the classification of primary cancers of the lung, a view which our case fully substantiates. Report of Case Clinical History: W. A., a white American salesman, aged forty-seven, was first seen by Dr. Charles W. Wainwright of Baltimore, on May 24, 1934, complaining of severe pain in the region of the left shoulder and down the left arm to the elbow. It had started about Sept. 1, 1933, and had increased in intensity. There was a history, also, of progressive weakness, loss of weight, and hoarseness. The early diagnosis was neuritis, but various forms of treatment were without effect.