Patient 1:

This is an older man who presented with increasing dyspnea and was found to have a right apical mass complicated by superior vena cava syndrome and Horner’s syndrome. The mass was later determined to be non-small cell lung cancer.

This patient also has Pemberton’s sign.

Patient 2:

This is an older man with metastatic prostate cancer who presented with unilateral ptosis and miosis after recently starting on immunotherapy with nivolumab. Imaging did not demonstrate any other explanation for Horner’s syndrome.

Patient 3:

This is an older woman with an extensive smoking history complicated by chronic obstructive pulmonary disease who presented with progressive dyspnea and weight loss, and was found to have elevated jugular venous pressure, dilated chest wall veins, and Horner’s syndrome. Chest imaging revealed a left apical mass that was later determined to be non-small cell lung cancer.

This patient also has dilated chest wall veins related to superior vena cava syndrome.