A 75-year-old male presented with chief complaint of pain in the right shoulder. CXR is shown below. Which of the following could be the cause of pain in this patient?: (A) Pancoast tumor, (B) Sarcoidosis, (C) Subclan aery aneurysm, (D) Mesothelioma
Answer is A. CXR shows a mass in the right lung apex and there is associated destruction of the right 2nd and 3rd ribs posteriorly. A combination of an apical mass along with the destruction of the rib is characteristic of Pancoast tumor/ Superior Sulcus Tumor. MRI is a more sensitive investigation in identifying the extension of tumor into adjacent soft tissue and bone.