Apical lung carcinoma commonly manifests as:September 2009

Ans. C: Homer's syndromeThe bulk of a true Pancoast tumor is extrathoracic, originating in an extreme peripheral location with a plaque like extension over the lung apex and principally involving the chest wall structures rather than the underlying lung parenchyma. Bronchogenic carcinomas occurring in the narrow confines of the thoracic inlet invade the lymphatics in the endothoracic fascia and include, by direct extension, the intercostal nerves, the lower roots of the brachial plexus, the stellate ganglion, the sympathetic chain, and adjacent ribs and veebrae.Carcinomas in the superior pulmonary sulcus produce Pancoast syndrome, thus causing pain in the shoulder and along the ulnar nerve distribution of the arm and hand. (These carcinomas also cause Horner syndrome.) These apical lung tumors tend to be locally invasive early.