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Man speaking with nurse about symptoms of a pancoast tumor


When a physician is working on 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 of a lung nodule into the top of the chest wall or vertebrae (superior sulcus of the pleural cavity), where Pancoast tumors usually invade.

Tests to diagnose a Pancoast tumor

Most often, the path to a Pancoast tumor diagnosis begins with an abnormal chest X-ray. From there, a physician may use one or more of the following tests:

  • CT scan (computed tomography) – This imaging test is more detailed than a chest X-ray.
  • PET scan (positron emission tomography) – These scans help evaluate whether the cancer has spread outside of the lung to such places as lymph nodes or other organs.
  • MRI scan (magnetic resonance imaging) – This type of imaging scan is usually the most accurate at identifying the extent of tumor involvement into the chest wall, nerves, vertebrae or blood vessels.
  • Biopsy – A needle biopsy is used to obtain cells from the mass for the pathologist to verify that it is indeed a lung cancer presenting as a Pancoast tumor.

Why is a Pancoast tumor difficult to diagnose?

The process of diagnosing a Pancoast tumor is not always as straightforward as running the tests mentioned above. Patients with Pancoast tumors often present with symptoms that are similar to the symptoms of less serious conditions, such as arthritis in the neck 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, the 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 lymphoid granulomatosis. This can further complicate the diagnostic process.

Medically reviewed by Dr. Lary Robinson

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.