パンコースト肺癌は肺尖部胸壁に浸潤し，進展すればパンコースト症候群を呈する予後不良な疾患である．従来，術前放射線療法が標準治療とされたが決して良好な成績ではなかった．著者は肺尖部を前方，正中，後方の3つに分類し腫瘍の局在によってアプローチを選択することが重要と考えた．後方から正中を占拠するパンコースト肺癌にはhookアプローチを開発し，前方を占拠する肺癌には前方アプロ―チにて完全切除率の向上に努めた．さらに早くから術前化学放射線療法を導入し治療成績の改善を図った．86例のパンコースト肺癌を経験し全体の5年生存率は48.7％（MST49.6カ月）であった．2000年までの前後期で分けると後期（n=49）の5年生存率は62.3％（MST未達）と前期の31.7％（MST12.7M）より有意に良好であった．腫瘍局在によるアプローチの選択，術前化学放射線療法の導入により劇的に予後を改善すること...

Superior pulmonary sulcus carcinoma, or Pancoast's tumor, was first identified in 1932 by H. K. Pancoast, who described a small tumor at the apex of the lung producing a characteristic pain pattern and rapid, universal mortality. Despite early indications that this type of carcinoma was amenable to neither radiation nor surgery, the current treatment approach calls for irradiation therapy (3,00...

Pancoast tumours are now amenable to multimodality treatment with an acceptable survival. This is because trimodality treatment improves tumor sterilization and hence outcome. Moreover the development of an anterior approach to access the tumor, further improved the technical challenges for a sound resection.The Anterior-manubrial sternal approach was described more than a decade ago and althou...

Introduction: The erector spinae plane (ESP) block is a regional anesthetic technique that involves injecting local below the muscle in an interfascial plane. Case Presentation: We report case of 66-year-old man with cervicothoracic junction pain caused by advanced Pancoast tumor. administration ESP at T2-T3 level led to relief more than 50% this patient after two sessions. Conclusions: Therefo...

We report on a patient with primary pulmonary adenoid cystic carcinoma presenting with Pancoast syndrome. Pancoast syndrome has not previously been described with this tumour. Other unusual features of this case include the peripheral origin and mediastinal involvement, with lack of proximal endobronchial spread.