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A 30-year-old male presents with atrophy of the intrinsic hand musculature, drooping of the eyelids, sunken eyeballs, lack of sweating and pupil constriction. Patient complaints include sudden pleuritic pain and a hoarse voice. What clinical condition is MOST likely related to these findings?

A. Thoracic outlet syndrome
B. Rib fracture
C. Cervical myelopathy
D. Pancoast tumor

User Tu
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Final answer:

The most likely condition related to the listed symptoms, which include features of Horner's syndrome and voice changes, is a Pancoast tumor. Horner's syndrome results from a disruption of the sympathetic chain by the tumor. Autonomic system regulation, particularly concerning cardiovascular disease, is critical in understanding such clinical presentations.

Step-by-step explanation:

The clinical condition most likely related to the symptoms described, including atrophy of the intrinsic hand musculature, drooping of the eyelids (ptosis), sunken eyeballs (enophthalmos), lack of sweating (anhidrosis) and pupil constriction (miosis), sudden pleuritic pain and a hoarse voice, is a Pancoast tumor. These are classic signs of Horner's syndrome, which can be caused by a tumor located in the apex of the lung that affects the sympathetic chain passing over the top of the lung and apex of the chest. Pancoast tumors can also involve the brachial plexus causing muscle atrophy and shoulder pain, as well as the recurrent laryngeal nerve leading to hoarseness. The lack of sweating and changes in pupil size are indicative of disruption to the autonomic nervous system pathways caused by the tumor.

Considering the autonomic system is essential in medical practice, especially related to cardiovascular disease, because autonomic tone plays a critical role in regulating heart rate and blood vessel tone. Horner's syndrome exemplifies the impact on autonomic function when an abnormality such as a thoracic tumor interferes with the neurological pathways.

User Laylaylom
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