Abstract
We report a case of Pancoast tumor found during treatment of postoperative pain. A 37-year-old male patient underwent thoracoscopic bulla resection of the left lung. He suffered from prolonged pain in his left chest and back after the operation, and had been treated with various kinds of nerve blocks and medication at several hospitals. He then visited our pain clinic because of prolonged intractable pain. Chest X-ray study showed the pleural thickening of the apex of the left lung. His pain was temporarily relieved with selective serotonin reuptake inhibitor, however, he gradually complained of pain and numbness in his left arm. We performed additional chest X-rays and MRI and found a Pancoast tumor with invasion of the left second rib. He received radiation therapy, chemotherapy and upper lobectomy of the left lung with chest wall resection, but metastasis in the kidney and adrenal gland were found, and he died nine months after the operation. This case suggested that we have to consider malignant disease when we examine patients with intractable pain.
