A 62-year-old male presenting with severe left-sided chest pain mimicking acute coronary syndrome was diagnosed with a Pancoast tumour (adenosquamous cell carcinoma) invading the chest wall.
Case Report (n=1)
Pancoast tumours can present atypically with severe chest pain mimicking acute coronary syndrome, highlighting the need for thorough neurological assessment and early imaging to prevent diagnostic delay.
Abstract English: Introduction Pancoast tumours account for approximately 3%–5% of lung cancers. Their atypical presentation often mimics cardiovascular, neurological or infectious conditions, particularly in tuberculosis-endemic regions, leading to delays in diagnosis and treatment. Case Presentation A 62-year-old male smoker presented with progressive, severe left-sided chest pain radiating to the back, scapula, neck and left upper extremity, accompanied by paraesthesia and reduced grip strength. The pain led to an initial evaluation for acute coronary syndrome and pulmonary tuberculosis. Electrocardiography showed no ischaemic changes, and sputum testing for Mycobacterium tuberculosis was negative. Chest radiography and contrast-enhanced thoracic computed tomography demonstrated a solid apical mass invading the chest wall and adjacent soft tissues, consistent with a Pancoast tumour. Neurological findings suggested lower brachial plexus involvement without Horner’s syndrome. Histopathological assessment confirmed adenosquamous cell carcinoma of the lung. Discussion This case highlights the diagnostic complexity of Pancoast tumours, which may present without prominent respiratory symptoms and instead mimic cardiac emergencies or endemic infections such as tuberculosis. Neurological deficits helped localise tumour invasion, highlighting the importance of thorough neurological assessment and early imaging. Conclusions Early recognition of atypical Pancoast tumour presentations is essential to prevent diagnostic delay and neurological deterioration, particularly in tuberculosis-endemic settings.
Alvianto et al. (Thu,) conducted a case report in Pancoast tumour (n=1). Diagnostic evaluation was evaluated on Diagnosis of Pancoast tumour. A 62-year-old male presenting with severe left-sided chest pain mimicking acute coronary syndrome was diagnosed with a Pancoast tumour (adenosquamous cell carcinoma) invading the chest wall.