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Pancoast’s syndrome caused by lymph node metastasis from breast cancer
  1. Vincenzo Di Stefano1,
  2. Cristina Valdesi1,
  3. Marinella Zilli2 and
  4. Marta Peri3
  1. 1 Department of Neuroscience, Imaging and Clinical Sciences, "G. d’Annunzio" University, Chieti, Italy
  2. 2 Medical Oncology Unit, "SS Annunziata" hospital, Chieti, Italy
  3. 3 Department of Medical, Oral and Biotechnological Sciences, "G. d’Annunzio" University, Chieti, Italy
  1. Correspondence to Dr Vincenzo Di Stefano, vincenzo19689{at}


Pancoast’s syndrome may be the result of neoplastic, inflammatory or infectious disease. We report an unusual case of Pancoast’s syndrome in a patient with metastatic breast cancer. A 54-year-old woman, affected by metastatic breast cancer, presented for severe shoulder pain, paraesthesia and numbness in the right arm. Despite further multiple lines of systemic chemotherapy, she developed a progressive enlargement of retropectoral, supraclavicular and infraclavicular lymph node metastases, which involved brachial plexus, apex of lung and anterior mediastinum. Physical examination revealed severe weakness of proximal muscles of the right arm. Neuropathic pain was managed with pharmacological treatment. Lastly, the patient has been treated with intrathecal analgesia with morphine and ziconotide with a good control of pain. The patient died after 3 months.

  • pain (neurology)
  • peripheral nerve disease
  • breast cancer
  • pain (palliative care)

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  • Contributors MP, VDS, MZ and CV provided clinical care to the patient, conception and design, acquisition of the data, analysis and interpretation of the data. MZ and VDS revised the article critically for intellectual content. All authors contributed to and have approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.