The disease was named after Henry Pancost, a radiologist, who described it as early as 1924.These are neoplasms arising on the uppermost part of the lung. They can appear from either side.
Definition of
This cancer is a subtype of lung cancer that develops in the upper part of the chest. A tumor can squeeze veins, a subclavian artery, a wandering or a laryngeal nerve.
Cancer of Pankosta is a kind of peripheral. It is located on the rotor of the lung, but unlike other forms, tumors that have arisen later cause the growth of abnormal tissues no further along the respiratory organ, but in the chest.
Most often such cells are found in:
- lymphatic system,
- sympathetic chains,
- intercostal nerves,
- ribs.
Causes of
As already noted, tobacco products abuse plays an important role in the formation of the disease. At the same time, the experience of smoking, the daily norm, the quality of tobacco is important.
Those who are passive smokers are also exposed to the disease. In this case, the risk of developing cancer is doubled.
The influence of other negative factors was proved.
Often oncological disease is formed by interaction with arsenic, chromium, nickel, asbestos, pesticides and other dangerous chemical ingredients.
In addition to industrial and chemical elements, the cancer of the apex of the lung can also appear in the presence of chronic processes in the lungs.
Its trigger mechanism can be chronic pneumonia, tuberculosis, pneumosclerosis, bronchoectatic disease. In addition, in recent years, scientists have raised the issue of hereditary predisposition, as well as the role of viruses in the process of formation of tumors.
Symptoms of Pancostic Cancer
The specificity of the disease is that at the initial stages the tumor rarely manifests itself as a lung disease. First, there is pain in the shoulder or the inside of the scapula. In the future, discomfort can spread to the inside of the hands, little finger and ring finger.
All the painful sensations arising from the defeat of the tip of the lung, differ in their incredible power. Therefore, narcotic painkillers are often prescribed to alleviate the condition.
Almost 10-25% of people due to compression of the spinal cord, paralysis of the lower half of the body occurs. Especially the process begins more quickly when new growths begin to spread to the intervertebral foramen.
Horner's syndrome develops due to the appearance of pathological processes in the neck and upper parts of the chest. Because of this happens:
- weak pupillary response,
- reddening of the skin from the side of the lesion,
- descent of the upper eyelid.
With such a syndrome, it is possible to draw a dull product over the skin, the strip that appears will remain for a long time.
Cancer of the apex of the lung with Pancost syndrome is expressed in the numbness of the forearm and hand, the weakness of the muscles on the arm.
Diagnosis
Doctors remind you that with this form of the disease, blood tests are not specific, and their results can not serve to establish an accurate diagnosis. Often the same procedures are used as usual, but there are some subtleties.
For example, in the early stages, Pancost's cancer is very poorly seen on an X-ray. This is due to the fact that this very section of the lung is not very well seen.
A negative role for this research is played by shadows, which lead to the fact that the image simply becomes unclear.
Often, an X-ray reveals small or large abnormal masses, reveals when the tumor has penetrated the ribs or vertebral column.
Effective is MRI, which allows to determine the degree of penetration of the tumor, lymph nodes, ribs, sternum tissue. This method is more accurate than CT scan because it allows a more accurate assessment of the patient's condition. However, CT can more accurately determine the environment and the penetration of the tumor into the lymph nodes.
When there is effusion in the pleural cavity, there is a need for transthoracic puncture. In this case, the needle is inserted into the tumor node and the contents are taken for the cytological examination. This method significantly improves the specificity of other diagnostic methods.
Treatment of pathology
Cancer of Pancost is one of those forms that is successfully treated with the use of radiotherapy. Especially if the metastases failed to penetrate the lymphatic system.
This method is used before the operation and as a monotherapy. The latter is relevant for those cases when it comes to tumors that can not be removed.
To reduce the spread of the tumor and increase the chances of recovery, neoadjuvant therapy is prescribed.
Chemotherapy is prescribed for lung cancer only in combination with radiotherapy or surgery. Its main task is to reduce the size of the tumor.
Forecast of
If Pancoast cancer was detected at an early stage, then with proper treatment the prognosis is considered conditional. This means that with the use of all known methods of treatment, the five-year survival rate is 30-46%.
The presence of metastases and Horner's syndrome leads to a less favorable prognosis.