Pancoast Tumor: A Rare presentation of Hepatocellular Carcinoma

  • Enam Murshed Khan Apollo Gleneagles Hospital, Kolkata, India
  • Arpita Sutradhar Apollo Gleneagles Hospital, Kolkata, India
Keywords: Pancoast tumor, Hepatocellular carcinoma, lung


Lung is the first most common site for metastasis of hepatocellular carcinoma. Pancoast’s tumor is usually caused by adenocarcinoma of lung. Hepatocellular carcinoma is very notorious in remaining asymptomatic for prolonged time.  But metastatic Hepatocellular carcinoma presenting as apical lobe lung mass eroding the ribs (Pancoast’s tumor) is unusual. We, describe here a 66year old male who presented with left shoulder pain which was subsequently diagnosed to be due to metastatic tumor of upper lobe lung from liver primary. To our knowledge Pancoast’s syndrome due to metastatic hepatocellular carcinoma is rare and only two cases have been reported previously to the best of our knowledge. This case report will allow the clinicians to consider metastatic HCC as a differential for Pancoast’s tumor.

Author Biographies

Enam Murshed Khan, Apollo Gleneagles Hospital, Kolkata, India
Dept. of Pathology
Arpita Sutradhar, Apollo Gleneagles Hospital, Kolkata, India
Dept. of Pathology


1.Christophoros N, Foroulis, Paul Z et al. Superior sulcus(Pancoast)tumors: current evidence on diagnosis and radical treatment. J Thoracic dis 2013;5(S4):S342-S358.
2.Katyal S, Oliver JH, Peterson MS, et al. Extrahepatic metastases of hepatocellular carcinoma. Radiology 200;216:698-703.
3.Arcasoy SM, Jett JR. Superior pulmonary sulcus tumors and Pancoast’s syndrome. N engl J Med 1997;337:1370-6.
4.Shih KL, Chen YY, Teng TH, Soon MS: Long term survival in a patient with repeated resections for lung metastasis after hepatectomy for ruptured hepatocellular carcinoma: a case report. J Med Case Reports 2008,2:222.
5.Honeybourne D: Lung metastases from a primary hepatocellular carcinoma. Thorax 1980,35:316-317.
6.Davis SD. CT Evaluation for pulmonary metastases in patients with extrathoracic malignancy. Radiology 1991;180:1-12.
7.Chao-Fu C, Wei-Juin S, The-Ying C et al. Hepatocellular Carcinoma with Pancoast’s Syndrome as an Initial Symptom: a Case Report. Jpn J Clin Oncol 2001;31(3)119-121.
8.Bosch FX, Ribes J, Cleries R, et al. Epidemiology of hepatocellular carcinoma. Clin Liver Dis2005;9:191-211.
9.Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology 2011;53:1020-2.
10.Annalisa K. Becker, David K Tso, Alison C Harris et al. Extrahepatic Metastases of Hepatocellular Carcinoma: A Spectrum of Imaging Findings. Canadian association of Radiologists Journal65(2014)60-66.
Case Report