# Pancoast (superior sulcus) tumour

Source: https://onco.cc/terms/pancoast-tumour/  
OnCo record `pancoast-tumour` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A lung cancer growing at the very top of the lung, where it presses on the nerves going to the arm and the nerves that control the eyelid and pupil. It usually announces itself as shoulder and arm pain rather than as a chest problem, so it is often treated as a shoulder injury first.

## Summary

A Pancoast or superior sulcus tumour is defined by where it is rather than by what it is: it is a lung cancer, usually non-small-cell, arising in the apex of the lung and invading the structures of the thoracic inlet. It is a presentation and a location, not a tumour entity in the WHO classification, which is why this corpus records it as a term rather than as a cancer page. The syndrome comes from what it invades: the lower brachial plexus, giving pain in the shoulder radiating down the inner arm to the fourth and fifth fingers with weakness and wasting of the hand; the sympathetic chain, giving Horner's syndrome, a drooping eyelid, a constricted pupil and loss of sweating on that side of the face; and sometimes the first ribs and vertebral bodies. Because the chest X-ray shadow sits at the apex behind the clavicle it is easy to miss, and because the symptoms are musculoskeletal these tumours are commonly managed as shoulder problems for months before a scan is done. MRI, not CT, is the test NICE NG122 names for assessing the extent of disease in superior sulcus tumours, because it shows plexus and vertebral involvement that CT does not. Treatment is a separate question from where it sits in the classification and is carried by the non-small-cell pages.

## Fields

- Kind: Term
- Last checked: 2026-09-25
- Also known as: Pancoast tumour; Pancoast tumor; superior sulcus tumour; superior sulcus tumor; apical lung tumour; Pancoast syndrome
- Tags: lung

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Pancoast_tumor
- NICE NG122: lung cancer, diagnosis and staging (published 28 March 2019, last updated 8 March 2024): https://www.nice.org.uk/guidance/ng122/chapter/Diagnosis-and-staging
- NHS: symptoms of lung cancer (when to see a GP, when to call 111 and when to call 999): https://www.nhs.uk/conditions/lung-cancer/symptoms/

## Connected records

- cancers: [Adenocarcinoma of the lung](https://onco.cc/cancers/lung-adenocarcinoma/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/), [Squamous cell carcinoma of the lung](https://onco.cc/cancers/lung-squamous-cell-carcinoma/)
- technologies: [CT (computed tomography)](https://onco.cc/technologies/ct/), [MRI](https://onco.cc/technologies/mri/)
- terms: [Haemoptysis (coughing up blood)](https://onco.cc/terms/haemoptysis/), [Resectability in lung cancer](https://onco.cc/terms/resectability-lung-cancer/), [Superior vena cava obstruction](https://onco.cc/terms/superior-vena-cava-obstruction/), [TNM 9: what changed in lung cancer staging](https://onco.cc/terms/tnm-9-lung-cancer/)

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JSON: https://onco.cc/api/v1/entities/pancoast-tumour.json