Figure 2.

A left pancoast tumour. a) Chest magnetic resonance imaging of a left pancoast tumour arising in the left upper lobe and infiltrating the first rib, brachial plexus and left subclavian artery. The patient received induction chemoradiotherapy: three cycles of vinorelbin and cisplatin, as well as 45 Gy. He underwent en bloc resection through sternotomy and supraclavicular approach, the left upper lobe and the three first ribs were removed and the left subclavian artery was reconstructed. The left phrenic and vagus nerves had to be sacrificed. Histopathology showed a primary lung adenocarcinoma with >90% necrosis. b) Chest radiography of the same patient 4 years post-operatively. There is obvious left phrenic nerve palsy. The patient had a positron emission tomography-computed tomography scan at 5 years which showed no sign of relapse.