When lung cancer arises in the superior pulmonary sulcus and is limited to the upper apical segments, but invades the para-apical structures, it is called a Pancoast tumor.Pancoast tumors spread contiguously to involve segments of the brachial plexus [. Although the MRI features of Pancoast tumors are nonspecific, the use of fat-suppression and contrast provides good differentiation of the tumor from the surrounding normal tissue. Bone and soft tissue tumors arising in the adjacent structures also involve vessels and nerves in the axilla . Osteosarcoma, aggressive fibromatosis, and Ewing sarcoma are some of the tumors that may cause brachial plexopathy. The MRI features resemble those of the primary tumor.
A 62-year-old male with a soft tissue sarcoma of the chest wall and axilla. The coronal STIR (A) and axial T2W (B) images show a hyperintense mass that infiltrates the cords of the brachial plexus with encasement of the axillary vessels (arrow)
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