Abstract

Prominent among the clinical phenomena were pain around the shoulder and down the inner side of the arm, and often the ulnar side of the forearm, loss of power and wasting of the muscles of the hand, Homer's syndrome and signs mainly of dulness [sic] in the apex of the chest. The roentgenographic appearances were a comparatively small and circumscribed shadow in the apex due to lung displacement, and destruction of the posterior portions of one or more ribs and the adjacent articular and transverse processes and possibly a little of the sides of the bodies of one or more vertebrae. There was a striking lack of intrathoracic metastasis. Practically all these characteristics are essential for the diagnosis of the lesion.1