A report of reflex sympathetic dystrophy due to Pancoast tumor

Abstract

A 57-year-old man was admitted with burning pain and swelling of his left arm. A chest X-ray film showed a tumor shadow in the apex of the left lung, squamous cell carcinoma was diagnosed by bronchoscopy and brush biopsy. A sweat test showed a significant decrease in sweating in the distribution from the stellate ganglion through T₃ on the left. The amplitude of the pulse in his left index finger was 4 times that on the right. Our diagnosis was reflex sympathetic dystrophy (RSD). After preoperative irradiation to the tumor (30 Gy), left upper lobectomy was performed followed by left sympathetic ganglionectomy from the lower stellate ganglion through T₃. The burning pain and edema of the left arm disappeared. We conclude that sympathetic ganglionectomy is very efficient in patients with RSD due to lung cancer.