This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous Questions, Subject name: Medicine
Pancoast tumour causes: 
Select and explain. 
A. Increased sweating, B. Wasting of muscles of hand, C. Destruction of lower ribs, D. Bony metastasis
B: Wasting of muscles of hand
Answer: B: Wasting of muscles of hand 
Explanation: Pancoast syndrome- neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet, involvement of the brachial plexus and cervical sympathetic nerves 1. Severe pain in the shoulder region radiating toward the axilla and scapula along the ulnar aspect of the muscles of the hand. 2. Radiologic destruction of the first and second ribs 3. Atrophy of hand and arm muscles 4. Horner syndrome 5. Compression of the blood vessels with edema * Most Pancoast tumors are adenocarcinomas >> squamous cell carcinomas. * Involvement of the phrenic or recurrent laryngeal nerve or SVC obstruction is not representative of the classic Pancoast tumor