Abstract
A 36 year old Caucasian male presented to the Emergency Department with right shoulder pain and associated right upper extremity weakness, increasing confusion, weight loss and night sweats. Chest X-ray revealed a pancoast tumor involving upper lobe of right lung with rib erosions. CT guided biopsy of the tumor was performed and histopathological analysis of the specimen showed a poorly differentiated carcinoma with sarcomatoid features. Further staging demonstrated invasion of the tumor into the brachial plexus and multiple metastasis to the brain, cervical and thoracic spine. The patient was commenced on levetiracetam and dexamethasone. He also received multiple cycles of palliative whole brain and lung radiation therapy. Unfortunately the patient died within three weeks of his initial diagnosis.
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