RT Journal Article SR Electronic T1 Pancoast tumour presenting as shoulder pain with Horner’s syndrome JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2018-227873 DO 10.1136/bcr-2018-227873 VO 12 IS 1 A1 Nimlan Shanmugathas A1 Kapil Mohan Rajwani A1 Shumontha Dev YR 2019 UL http://casereports.bmj.com/content/12/1/bcr-2018-227873.abstract AB 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.