title: Pancoast tumors: characteristics and preoperative assessment.
abstract: Superior sulcus tumors (SSTs), or as otherwise known Pancoast tumors, make up a clinically unique and challenging subset of non-small cell carcinoma of the lung (NSCLC). Although the outcome of patients with this disease has traditionally been poor, recent developments have contributed to a significant improvement in prognosis of SST patients. The combination of severe and unrelenting shoulder and arm pain along the distribution of the eighth cervical and first and second thoracic nerve trunks, Horner's syndrome (ptosis, miosis, and anhidrosis) and atrophy of the intrinsic hand muscles comprises a clinical entity named as "Pancoast-Tobias syndrome". Apart NSCLC, other lesions may, although less frequently, result in Pancoast syndrome. In the current review we will present the main characteristics of the disease and focus on the preoperative assessment.
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Panagopoulos
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Leivaditis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Koletsis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Prokakis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Alexopoulos
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Baltayiannis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Hatzimichalis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Kosmas
authors.initials: K
authors.lastname: Tsakiridis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katsikogiannis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Kougioumtzi
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Machairiotis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Tsiouda
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Kesisis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Siminelakis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Madesis
authors.affiliation: 1 Department of Cardiothoracic Surgery, Patras University School of Medicine, 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Oncology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 8 Cardiothoracic Surgery Department, University of Ioannina, Ioannina, Greece ; 9 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dougenis
keywords: Pancoast; lung cancer; surgery