Definition and Diagnosis

Direct tumor spread, or metastatic deposits in lymph nodes, may invade and damage important nerves in the neck, axilla, and pelvis. It is often quite painful, causing pain to shoot down the arm or leg. Numbness and weakness may also occur. MRI and PET scans help define the tumor and nearby nerves (e.g., brachial plexus or lumbosacral plexus). A relatively common type of tumor to invade the brachial plexus is lung cancer at the lung apex (Pancoast tumor). This causes pain to radiate under the arm to the small finger. Hand weakness can also occur.

Treatment Options

Tumors can be treated with chemotherapy, radiation, and/or surgery. Options depend on the type of cancer and what treatments have been used in the past. Pancoast tumors can be removed with or without a portion of the brachial plexus to optimize patient survival. Removal of tumors involving nerves often involves both an oncologic surgeon as well as a peripheral nerve surgeon.