Patients presenting with shoulder and arm pain can be a diagnostic challenge to the attending chiropractor. Although the majority of conditions presenting to a chiropractor are benign, occasionally a malignant life threatening one will present. One such condition is a Pancoast tumour, a cancerous growth developing in the lung apex. The resultant clinical entity, the Pancoast syndrome, presents as severe pain in the neck, shoulder and arm, and a Horner’s syndrome. It typically affects middle aged men who have a history of smoking. Pancoast tunours are frequently missed resulting in a delayed diagnosis. Appropriate chest radiographs are imperative in making the diagnosis. This report presents the clinical presentation and a case of Pancoast tumour, and emphasizes the importance of its inclusion in the differential diagnosis of patients presenting with persistent neck and shoulder pain.
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