QuestionSBA
QuestionChoice
This describes prominence of the eyes out of the skull and it occurs in graves disease (hyperthyroidism). It is not typically associated with pancoast lung tumours
10005638
c
Exophthalmos
QuestionChoice
Pancoast tumours can compress the sympathetic chain, causing a collection of symptoms (Horner's syndrome). Sympathetic innervation to the pupil causes dilation and so if damaged there is paralysis of the dilator pupillae muscle and so the pupil is constricted.
10005636
a
Miosis
QuestionChoice
This is the opposite of what is expected and would occur if parasympathetic innervation to the pupils was damaged or in response to raised intracranial pressure.
10005637
b
Fixed and dilated pupils
QuestionChoice
As the sympathetic chain is damaged, there is usually decreased sweating.
10005639
d
Increased sweating
QuestionChoice
This occurs in a facial nerve palsy, such as Bell's palsy. In Pancoast tumours, there is typically partial ptosis/drooping of the upper eyelid.
10005640
e
Unilateral full facial drop/paralysis
Concept
Chapter
2693
4430
Horner's syndrome
Topic
140
Ophthalmology
13674
A 68-year-old male with a known pancoast tumour (apical lung cancer) presents with symptoms that have occurred due to compression of the sympathetic chain.

Which of these signs/symptoms is the patient most likely to have?
a