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Pancoast tumour presenting as shoulder pain with Horner’s syndrome
  1. Nimlan Shanmugathas1,
  2. Kapil Mohan Rajwani2 and
  3. Shumontha Dev3
  1. 1 Emergency Department, Guy’s & St Thomas’ Hospitals, London, UK
  2. 2 Department of Neurosurgery, Brighton and Sussex University Hospitals, West Sussex, UK
  3. 3 Emergency Department, Guy’s and Saint Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Shumontha Dev,{at}


A 54-year-old man presented to the emergency department with a 4-week history of right shoulder pain radiating down his arm, with some associated sensory loss. Further questioning and examination in the department revealed a classical Horner’s syndrome; miosis, partial ptosis and hemifacial anhidrosis. An initial chest X-ray was deemed to be unremarkable; however, further review by a radiologist noted asymmetrical right apical thickening. A subsequent high-resolution CT scan of the chest revealed a right-sided Pancoast tumour. This case highlights the importance of a thorough history and examination in identifying a rare cause of shoulder and/or back pain.

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  • Patient consent for publication Obtained.

  • Contributors NS and KMR saw the patient in the emergency department and wrote the article. SD had given advice to write up the case and edited the article.

  • 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.

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

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