Case Report with a Review of Literature: Pancoast Syndrome—A Rare Presentation of Metastatic Hepatocellular Carcinoma

Abstract Superior sulcus tumors, also known as Pancoast tumors, present in a distinctive way with Horner's syndrome (ptosis, miosis, and anhidrosis), hand weakness brought on by the atrophy of the intrinsic hand muscles, and excruciating pain along the medial aspect of the arm. (1) Primary lung cancers constitute a majority of Pancoast tumors, but Pancoast syndrome can be multifactorial. (2) Here, we present a case of 62-year-old male who presented with right shoulder pain and weakness for 2 months. Clinically, he had a supraclavicular mass with atrophy of the intrinsic muscles of the hand and sensory-motor weakness. Computed tomography showed a mass lesion in the supraclavicular fossa with the erosion of the T1 vertebra and first rib, mimicking carcinoma right upper lobe. However, the biopsy from the mass was suggestive of metastasis from hepatocellular carcinoma (HCC). Our case report identifies HCC as a rare differential for Pancoast syndrome and highlights the unique metastatic presentation.