Henry Pancoast

Henry Khunrath Pancoast (1875 – 1939)

Henry Khunrath Pancoast (1875-1939) was an American radiologist.

Pancoast was the First Professor of Radiology in America. The Pancoast tumour and Pancoast Syndrome are  named after him.

Major work on studying the healthy chest; interpretation of silicosis, tuberculosis and pneumoconiosis X-ray; bismuth shadow interrogation of the intracranial lesions; radiotherapeutic intervention


Biography
  • Born on February 26, 1875 in Philadelphia, USA (father Dr Seth Pancoast)
  • 1892 – Graduated Friend’s Central School, Pennsylvania. Delayed plans to enter medical school due to the premature death of both his parents. Became a bank teller for 2 years and started Medical School in 1894 with no undergraduate premedical preparation
  • 1898 – Graduated medical school from the University of Pennsylvania
  • 1900 – Commenced surgical training Hospital of the University of Pennsylvania
  • 1903 – Asked to join the Hospital ‘Roentgen Ray Department’ as a sciagrapher. He later remarked: “How easy it was in those days to become a radiologist by the shortest affirmative reply!
  • 1911 – First Professor of Roentgenology (Radiology) in the United States
  • 1915 – Use of radium to treat inoperable carcinoma, brain tumors, uterine hemorrhage, warts, and moles
  • Died on May 20, 1939

Medical Eponyms
Pancoast Tumour

Pancoast tumors are usually non-small cell lung cancer (NSCLC) and interchangeably referred to as Pancoast Tumours.

Pancoast 1932 Case 7

Fig. 3 (case 7).—Roentgenogram of the chest, showing the circumscribed apical shadow. Note the upper arrows pointing to the second rib and to the head and neck of the first rib, both of which are intact. Pancoast 1932

Pancoast syndrome

Pancoast Syndrome occurs secondary to local compression of brachial plexus and sympathetic chain by superior (pulmonary) sulcus tumors. Syndrome consists of:

  • Shoulder pain: initially localised to shoulder and vertebral border of scapula)
  • Radicular pain C8-T2: Progressive ulna nerve distribution pain and muscular atrophy
  • Horner syndrome: present in 25% of presentations of Superior sulcus tumors. Extension of neoplastic invasion/compression to involve sympathetic chain and stellate ganglion
Pancoast 1924 Case 10
Fig 10: The appearances due to sympathetic paralysis are well illustrated in a case of lymphosarcoma of the neck with the larger mass on the left side. The patient has pain referred down the left arm and in the third, fourth and fifth fingers, and loss of tactile and pain sensations on the inner side of the right forearm; wrist extension is weak, and there is no grip in the hand. There is very noticeable ptosis of the left lid, contracted pupil and a suggestion of hemiatrophy of the face. Sweating occurs only on the right or opposite side of the face. Pancoast 1924

Major Publications

Controversies

Pancoast was not the first to describe the neoplasm or the associated syndrome associated with local invasion

  • British surgeon Edward Selleck Hare (1812-1838) first described in 1838.
  • Publio Ciuffini described lung apical tumor with local invasion in 1911.
  • Pancoast described three cases in 1924 and in 1932 described the tumor as a “superior pulmonary sulcus tumor”. Pancoast incorrectly described the tumors as ‘arsing from epitheleal rests of the 5th brachial cleft’.
  • J. W. Tobías correctly surmised the tumor site of origin as bronchopulmonary tissue in his 1932 publication

References

Biography

Eponymous terms

Our Pancoast thinks everyone crazy
Who works without skiagrams hazy,
In fact you would laugh
To hear the whole staff
Rave on as if they were X-rasy

University of Pennsylvania, Scope Yearbook – 1912


Cite this article as: Thomas Morey and Mike Cadogan, "Henry Pancoast," In: LITFL - Life in the FastLane, Accessed on January 29, 2023, https://litfl.com/henry-khunrath-pancoast/.

eponym

the person behind the name

Emergency medicine RMO at Sir Charles Gairdner Hospital with a keen interest in cardiorespiratory medicine, intensive care and anaesthetics. MBBS, GKT School of medicine. BSc in Biomedical engineering and material science, Barts & The London.

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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