A 68-year-old chronic smoker presents with hoarseness of voice, right-sided ptosis with miosis, and a 3 cm right apical lung mass on chest X-ray. Which anatomical structure is responsible for the ocular findings?
- A Recurrent laryngeal nerve
- B Cervicothoracic (stellate) ganglion ✓
- C Superior vena cava
- D Phrenic nerve
Correct answer: B. Cervicothoracic (stellate) ganglion
Explanation
This is Pancoast tumor (superior sulcus tumor) causing Horner syndrome (ptosis, miosis, anhidrosis) due to invasion of the cervicothoracic (stellate) ganglion. The recurrent laryngeal nerve causes hoarseness. SVC obstruction causes facial edema and distended neck veins. Phrenic nerve palsy causes diaphragmatic paralysis. The combination of apical mass with Horner syndrome is pathognomonic for Pancoast tumor.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.