Thoracic Inlet Tumors

Abstract

The clinical features of 94 cases of thoracic inlet tumor were reviewed. Pain was the outstanding symptom in 96% of patients, and in 79% there were signs and symptoms of involvement of the nervous system. Despite the fact that pain was the initial symptom in 92% of patients, diagnosis was too often delayed while treatment for shoulder and cervical spinal column disorders was given. Diagnosis was often made difficult because of the inconspicuous location of the lesion at the apex of the lung. Examination of sputum gave positive results in 16% of patients. Perhaps the best approach for obtaining tissue for diagnosis is through an extended supraclavicular exploration. Six patients survived at least 5 yr. after diagnosis and 5 of these are still alive. Two were treated by irradiation alone, 2 by surgical resection and irradiation, and one by pneumonectomy and chemotherapy. The hopeless prognosis described for this type of tumor in the past is no longer justified. Early diagnosis and energetic treatment can result in apparent cure.