Differential Diagnosis Of Cervical Radiculopathy And Superior Pulmonary Sulcus Tumor: 10 Cases Review

Objective:To study the differential diagnosis methods between cervical radiculopathy and superior pulmonary sulcus tumor (Pancoast tumor). Methods:Clinical manifestations, physical and radiological findings of 10 patients, whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor, were reviewed and compared with those of cervical radiculopathy. Results:Superior pulmonary sulcus tumor patients have shorter mean history and fewer complain of neck pain or limitation of neck movement range. Physical exam showed almost normal cervical spine range of motion. Spurling's neck compression test was negative in all patients. Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in 1 case. The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI. Conclusions:By the method of combination of history, physical exam and radiological findings, superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy. Normal motion range of cervical spine, negative Spurling's neck compression test and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considered as indications for further chest radiograph exams.