Neuroimaging features of Pancoast tumor invading the lower brachial plexus

Seventy-nine-year-old with a long smoking history presents with neck and arm pain and left arm weakness. (A) Portable, upright chest radiograph shows mass (arrow) in left lung apex. (B) Sagittal, (C) coronal, and (D) transverse-axial precontrast and (E) postcontrast T1-weighted MRIs show necrotic mass in the posterior costovertebral sulcus of the left lung that extends through the chest wall into the lower trunks and divisions of the left brachial plexus (thick arrows). The subclavian artery is indicated by arrowheads.