Chest Pancoast tumour 001

Radiological Report : XR Chest :

Unfortunately I have no previous films for comparison. Extensive changes are present over the right apex including air space consolidation and pronounced pleural thickening. Where was the previous chest x-ray performed?

Radiological Report : MRI Spine Cervical and Upper Chest :

T1 and T2 sagittal sequences plus T2 axial images were performed through the cervical spine and T1 and T2 axial images and T1 and STIR coronal images through the upper chest. As identified on the CT scan, there is an 8.6cm cavitating mass at the right apex.

 This invades the superior mediastinum invaginating around the SVC and extends into the soft tissues of the supraclavicular fossa. There significant apical pleural thickening.

The tumor extends medially to involve the C7 vertebral body and the posterior aspect of the T1 vertebral body and tumour tissue extends through the neural exit foramina and bone to lie within the spinal canal where it indents the thecal sac and slightly deviates the lower cervical and upper thoracic cord to the left.

CONCLUSION: There is a large cavitating tumour at the right apex with destruction of the right first rib, involvement of the C7 and T1 vertebra and extension through the neural exit foramina to the spinal canal. There is extensive invasion beyond the lung superiorly into the soft tissues of the supraclavicular fossa and also direct mediastinal invasion with partial encasement of the SVC. Marked apical pleural thickening is also noted.