Pancoast-Tobias Syndrome Due to a High-Grade Fibrous Histiocytoma: A Case Report

Bronchogenic cancers account for an overwhelming majority of all malignancies responsible for Pancoast syndrome. However, the spectrum of non-bronchogenic malignant causes is broad and although less frequent, they are characterized by late diagnosis at advanced disease stage with a poor prognosis. The clinical presentation of Pancoast tumors can be polymorphic based on the etiology and anatomic extent, leading to considerable delays in the request of appropriate investigative techniques. Chest radiography may be helpful in first-line imaging but the cross-sectional modalities are more sensitive for diagnosis, staging and follow-up of treatment. Early reporting of symptoms and increased clinical vigilance could lead to an early diagnosis and improved 5-year survival. We report the case of a 40-year-old male with worsening left shoulder and arm pain over the course of a few months and a left neck swelling.