Pancoast Tumor Diagnosis

When a physician is working toward a Pancoast tumor diagnosis, he or she will usually request several different tests. The process typically begins with one or more imaging scans, which can reveal whether or not there is a growth in the top of the lung (pulmonary apex), where Pancoast tumors originate.

Because they have had an abnormal chest X-ray, most patients will then have a chest CT scan.

Usually the next step is to obtain a PET scan (positron emission tomography) in order to evaluate whether the cancer has spread outside of the pulmonary apex to such places as lymph nodes or other organs. Lung cancers use a large amount of sugar (glucose) as their energy source so that the glucose-like material injected for the PET scan will show up brightly positive wherever the tumor has spread.

If the Pancoast tumor appears localized, physicians will order a MRI (magnetic resonance imaging) scan because this test is usually the most accurate at identifying the extent of tumor involvement into the chest wall, nerves, vertebrae or even blood vessels. This is particularly important for the surgeon in order to determine whether it will be possible to realistically remove the cancer at some point.

Once the scans verify the presence of an abnormal growth, the physician will then request a needle biopsy to obtain cells from the mass for the pathologist to verify that this is indeed a lung cancer presenting as a Pancoast tumor. Although this is the “ideal” path to a Pancoast tumor diagnosis, the process is not always quite so straightforward. Patients with Pancoast tumors often present with symptoms that are similar to the symptoms of less serious conditions, such as cervical arthritis or degenerative disease of the shoulder. As a result, their physician may not suspect cancer until the symptoms get progressively worse or a surprise growth in the lung is found on a chest X-ray. Additionally, Pancoast syndrome, a collection of individual symptoms such as shoulder or arm pain experienced together, is typically reported by Pancoast tumor patients. Very rarely some of these symptoms might be caused by other malignancies, such as lymphoma or lymphatoid granulomatosis. This can further complicate the diagnostic process.

While some physicians may never have diagnosed one of these uncommon lung malignancies, Moffitt Cancer Center’s highly experienced oncologists specializing in lung cancer have helped many Pancoast tumor patients get the answers they deserve. Whether you’re dealing with unusual symptoms that your primary physician just can’t pinpoint, or you have already received a Pancoast tumor diagnosis and would like a second opinion, we’re here to help.  To schedule a visit at Moffitt Cancer Center, call 1-888-663-3488 or fill out a new patient registration form. No referral is required.