Intra-thoracic infiltration

Intra-thoracic invasion by tumours results in symptoms and signs according to the location of the tumour:

Apex:

• Horner's syndrome due to sympathetic ganglion invasion by a Pancoast's tumour
• rib destruction
• arm pain and weakness due to brachial plexus invasion

Left hilum:

• hoarseness due to recurrent laryngeal nerve invasion

Mediastinum:

• cardiac tamponade or pericardial invasion
• arrhythmias
• dysphagia due to oesophageal invasion
• diaphragmatic palsy due to phrenic nerve invasion
• central chest pain due to chest wall invasion

Chest wall invasion:

• pleural effusion
• pleuritic chest

Right paratracheal:

• superior vena cava obstruction due to SVC compression or invasion