Lao Sun is a patient I received at the outpatient clinic and admitted to his hospitalization. The old grandson, who just passed 55 this year, had a relatively hard life when he was young, did a lot of hard work, often had a faint pain in his shoulders, and did not take it too seriously. A month ago, Lao Sun's right shoulder began to hurt again, thinking that he was an old man, he went to the physiotherapy hall near his home for massage and applied plaster to himself. However, this time, his shoulder pain did not slowly ease, but became more and more painful, sometimes he could not lift his hands when he dressed, and even when he slept at night, the pain was so much that it was difficult to fall asleep.
After being tortured by shoulder pain for more than half a month, Lao Sun decided to go to the hospital to see, and the orthopedic doctor listened to the description of the condition and recommended him to do a shoulder X-ray examination, and there was no abnormality in the shoulder joint. Doctors then suggested that he do another chest CT, which found problems. A 2.5 cm mass at the tip of the upper lobe of the right lung, highly suspected of lung cancer. Therefore, Lao Sun came to the outpatient clinic to prepare for hospitalization and diagnosis. Final puncture pathology reports suggest lung adenocarcinoma. Went to surgical resection and is currently recovering well.
Shoulder pain actually detected lung cancer!
Many people can't help but worry that their regular shoulder pain will not be a bad disease. It is true that some lung cancers of the upper lobe, especially the cusp of the lungs, have shoulder pain as the first symptom. Just above the tip of the lung is the thoracic outlet, and there are many nerves in the surrounding area, through which nerve fibers from the neck, the sensations that innervate the upper limb, and movement enter the upper limb. When a tumor appears at the apex of the lung and continues to enlarge, it will compress the pleura at the tip of the lung and the surrounding parts, and symptoms similar to frozen shoulder and pain in the shoulder and back muscles will appear, which often require analgesics to be relieved.
There is a medical term called Pancoast syndrome, also known as pulmonary apex tumor syndrome, which refers to a group of symptoms of intractable pain in the upper extremities and shoulders caused by tumor infiltration and compression at the apex of the lungs and ipsilateral Horner syndrome. The most common tumors that cause Pancoast syndrome are lung cancer, others include pleural mesothelioma, breast cancer, thyroid cancer, esophageal cancer, and metastatic cancer at the tip of the lung. Tumor compression of the cervical sympathetic nerves causes ipsilateral miosis, sagging upper eyelids, and lack of sweating in the forehead, which is called Horner syndrome.
When shoulder pain occurs, don't panic and think it might be lung cancer. In fact, there are too many benign diseases that cause shoulder pain. The most common include rotator cuff injuries, cervical spondylosis, frozen shoulder, deltoid bursitis, and even cholecystitis, which can cause shoulder pain.
Compared with benign diseases, tumor-related shoulder and back pain has its characteristics, Dr. Chen Qunshan of the Pain Department of the Second Affiliated Hospital of Zhejiang University Medical College summed up two characteristics: 1. Pain sensation is often difficult to describe clearly, like soreness, numbness, but it seems that it is not; 2. It is not obvious during the day, the pain is aggravated at night, it is difficult to fall asleep no matter what position when sleeping, lying on the stomach and kneeling is more comfortable than lying down.
When the shoulder after physiotherapy, massage, external medication and other measures can not alleviate the pain, or the pain gradually worsens, then to increase vigilance, especially some lung cancer high-risk groups, at this time can be timely to the hospital to do the corresponding examination, the most direct examination method is chest flat scan CT, chest low-dose spiral CT is a screening method for high-risk groups of lung cancer.