Two cases of Pancoast tumor where cervical root block was effective in pain relief, which resulted in continuation of cancer treatment

Abstract

We report two cases of Pancoast tumor where cervical root block at a site not directly affected by the tumor was effective in pain relief, which resulted in continuation of cancer treatment. In case 1, the patient complained about pain around the right scapula. Pancoast's syndrome was thought to be the cause, but direct nerve block to the site seemed to be difficult. Therefore, we performed right C5, 6 root block which can provide pain relief around the scapula, and he got pain relief. In case 2, the patient complained about left upper limb pain. Computed tomography showed C6–T2 vertebral compression fractures due to invasion of a right Pancoast tumor, which were considered to cause his complain. However, based on physical examination, we suspected that the cause was C5 radiculopathy. We performed a C5 root block diagnostically and he got pain relief. In both cases, pulsed radiofrequency was performed, and long-term analgesia was obtained. Continuation of cancer treatment was possible due to improved performance status after root block.