Pancoast tumor approach through oesophagus

Abstract

Patient with Pancoast Tumor usually present in advanced stage of the disease which requires chemotherapy and radiotherapy as options of treatment. Histologic confirmation is a key for further treatment of these patients. Normally in bronchoscopy the lesion can't be visualised and in result making biopsy difficult to perform. Transthoracic biopsy through computed tomography poses anatomic difficulties and not always the pulmonary lesion can be reached.We report a case of pancoast tumor in a 68 year old male who presented with left arm pain and upper lobe increased density mass in chest x ray. Computed tomography confirmed an upper lobe mass of the left lung with invasion of the chest wall. It was successfully diagnosed with biopsy taken through the oesophagus of intrapulmonary mass with the EBUS bronchoscope (EUS- B FNA). No complication were observed during and after the procedure.To our knowledge this is the first case of making the diagnosis of lung carcinoma Pancoast tumor using EBUS bronchoscope with approach through oesophagus (EUS-B FNA). There may be a role in using EBUS specifically to diagnose a pancoast tumor in the right patient population.

EUS-B for the Interventional Pulmonologist Using the EBUS Scope in the Esophagus

“…The utility of EBUS and EUS-B is not limited to staging or diagnosis of lung cancer. The EBUS has well documented advantages in diagnosing mediastinal lymphoma [9][10][11], sarcoidosis [12][13][14], tuberculosis [15,16], pulmonary parenchymal masses [17,18], and metastatic disease to the mediastinum [19], among others including infections [9,20]. EUS-B has the same ability to investigate the mediastinum when such conditions are suspected, since the utility of EUS is well documented in such disease states [21,22].…”