title: A Case of Pancoast Tumor with Unusual Presentation.
abstract: BACKGROUND
  The Pancoast syndrome (PS) has been termed after Henry Pancoast. Its neurologic core symptoms include pain, radicular sensory and motor syndromes, and Horner syndrome. A PS is often the presenting sign of lung cancer and bears a grim prognosis.
  
  
  METHODS
  This case report describes an atypical onset of a lung tumor causing a PS. Electrophysiological examination was not conclusive. The diagnosis was confirmed by MRI, CT scan, and biopsy. The intervention consisted of preoperative chemo- and radiotherapy and was followed by an extensive surgical approach with histologically confirmed perineural invasion of the brachial plexus.
  
  
  RESULTS
  The postoperative period was dominated by neuropathic pain. Despite considerable loss of distal sensorimotor function of the right hand, the patient uses the extremity and has returned to professional life.
  
  
  CONCLUSIONS
  This observation triggered by the advances in general oncology and surgery also demonstrates the management of a lesion of the peripheral nervous system caused by cancer.
authors.affiliation: Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Calabek
authors.affiliation: Department of Radiology, Kaiser Franz Josef-Hospital, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Meng
authors.affiliation: Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Pollanz
authors.affiliation: Department of Thoracic Surgery, University Hospital of Vienna, Vienna, Austria.
authors.forename: Walter
authors.initials: W
authors.lastname: Klepetko
authors.affiliation: Department of Thoracic Surgery, University Hospital of Vienna, Vienna, Austria.
authors.forename: Konrad
authors.initials: K
authors.lastname: Hoetzenecker
authors.affiliation: Clinical Institute of Pathology, University Hospital of Vienna, Vienna, Austria.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Oberndorfer
authors.affiliation: Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Grisold
keywords: Pancoast tumor; brachial plexus; lung cancer; nerve infiltration; outcome; surgical resection