Discussions By Condition: I cannot get a diagnosis.

Pancoast Tumor?

Posted In: I cannot get a diagnosis. 8 Replies
  • Posted By: bpottberg
  • June 27, 2008
  • 07:17 PM


1. Severe right shoulder/back pain mostly mornings; 7 to 8 on a scale of 1 to 10. Pain will decrease during the day some days; wake me up at night.
2. Upper right arm pain (deep)
3. Numbness right hand
4. Full range of movement with shoulder no add. pain same with neck (except a bit more pain when chin touches chest)

Have had these about a month and a half.

5. Weakness in knees / unsteadiness in knees

Just occuring

My GP sent me to ortho (shoulder pain) shoulder x-ray negative / c-spine x-ray, ortho saw some arthritis. GP said everyone gets that as they get older.

Scheduled to see Neuro on 7/16.

Background: 40yo, non-smoker, occasional drink (mostly weekends), a bit overweight (high +BMI).

Thanks, Brad

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8 Replies:

  • This is Bob in arizona. My father died in 2001 from pancoast tumor. It was in is left upper left lob of the lung. He was 68 when he passed. I can tell you he had sholder pain for many years and the diagonised him with bersitiest ( excuse my spelling) When the cancer was more advanced he said he had bad pain from hisleft shoulder that ran down his left arm to his fingers. He said his arm was numb and tingiling feeling. I told him you know what that is becuase 10 years prior he had a tripple bypass and prior to that had left arm pain. But it wasnt this time. He didnt want to go to the doctor. He was estremely fatigued and had a hard time standing. He cooked dinner leaning his head on the kitchen cabinets. With the fatigue he had cold sweats and drank a lot of water. He just wanted to sleep and constantly complained about his left shoulder and arm hurting. One morning I went to visit and he was laying on the couch with cold sweats and his eyes were yellow from jaundace. I told him I didnt care what he said I was taking him to the doctor. After a few tests found a mass in his left lung and by time we cuaght it they said it messatized through his chest cavitiy and he had aggressive radiation but to no avail. Could not remove mass since it messatized to his hearts arterys and had no atrerys to use since they used them all in his tripple bypass years ago. Pancoast tumor is the most aggressive cancer that exsists. Please go to the doctor and insist on a x ray of your lungs. If you can catch it soon enough you can survive. I pray to God that you do not have this. Sincerly,Bob
    Anonymous 42789 Replies Flag this Response
  • Brad, my husband had a hernia in the upper shoulder, spinal area...it was not even visible, or even just barely visible (one doc saw it one did not...) on the MRI, but for some even a little protrusion from the bone in that area can be very painful. When he put his arm over his head, this position seemed to help. The only real cure in his case, was rest and not to over work and not do activities that aggrivate it (in his case typing on computer). He took some pain medication and such, but it was the rest that helped...recovery can vary, but in his case about 4 weeks ....some folks the protrusion is quite bad and they have an operation...my huband was not to this point. You might want to check into this...he got numb hands, arm, and fingers and shoulder pain on that side...perhaps your sleeping position is aggrevating it. Joan
    Joan5555 316 Replies Flag this Response
  • Thanks for the replies. A couple things, 1) going to see a neurologist tomorrow (instead of waiting until 7.16) and 2) don't think it is Pancoast. The sever pain I have had in my right should is now in my left shoulder, shooting down to the elbow. Pain increases with neck movement, so I think its an impingement somewhere along the spinal canal. BP
    bpottberg 4 Replies Flag this Response
  • What is thoracic outlet syndrome? Thoracic outlet syndrome is a condition whereby symptoms are produced from compression of nerves or blood vessels, or both, because of an inadequate passageway through an area (thoracic outlet) between the base of the neck and the armpit. The thoracic outlet is surrounded by muscle, bone, and other tissues. Any condition that results in enlargement or movement of the tissues of or near the thoracic outlet can cause the thoracic outlet syndrome. These conditions include muscle enlargement (such as from weight lifting), injuries, an extra rib from the neck at birth (cervical rib), weight gain, and tumors at the top of the lung (rare). Often no specific cause is found. It is felt by some researchers that the evolution of the torso of primates from a four-legged to a two-legged position may predispose humans to the development of thoracic outlet syndrome. The resulting vertical posture produced flattening of the chest cage and a shift of the shoulder joint backward, both of which narrowed the thoracic outlet.more info: http://www.medicinenet.com/thoracic_outlet_syndrome/article.htm
    dizzy lizzie 192 Replies Flag this Response
  • Latest Update: The pain in the right arm has become dull, but sometimes pain goes 7 to 8. Right arm is weaker than left sometimes considerably more. MRI tomorrow (7/15) C-Spine no contrast. Will continue to follow up as I know more. Thanks for the feedback.
    bpottberg 4 Replies Flag this Response
  • Latest Update: Neuro put me on anti-inflammatory on 7/3 not much help; pain remains dull but does get sharp 7-8 on occassion not due to any particular movement. Arm weakness continues to increase and the arm has become more spastic. Neuro called said C5 - C6 area has some arthritis / slippage not too bad, but somewhat atypical. Going for EMG on both arms 7/30. Concerned that the anti-infl didn't help much; seemed to increase the arm weakness and spasticity of the arm. Pain continues at base of neck and shoulder. Brad--
    bpottberg 4 Replies Flag this Response
  • July 23 Update EMG Exam on Monday was painful, but does not seem to have resulted in much. Dr. mentioned pinched nerve in shoulder. Current symptoms included dull pain in right shoulder, neck, and scapula radiating down into upper arm. But now having spasms in arm resulting in uncontroled constriction of the arm, briefly, but happens in a series of 3 to 4 times. I am getting nervous that I cannot get a straight diagnosis, and I am wondering if I should request of the neuro to send me for a brain scan. Brad
    bpottberg 4 Replies Flag this Response
  • I really think you should mention TOS (posted info above). If you read the article, the lady whose story is profiled is very similar to your experience.
    dizzy lizzie 192 Replies Flag this Response
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