This is likely a right-sided Pancoast tumor (superior sulcus tumor) — an apical lung cancer invading local structures.56

Hoarse voice

• Caused by recurrent laryngeal nerve involvement (or compression of the vagus nerve), leading to vocal cord paralysis.26
• The right recurrent laryngeal nerve can be affected by a right apical or hilar/mediastinal mass, though left-sided involvement is more common overall due to anatomy.5

Inability to lift right fingers

• This points to brachial plexus invasion (typically lower trunk, C8-T1, but can involve other parts causing finger/wrist extension weakness).55
• Pancoast tumors classically cause shoulder/arm pain, hand weakness, numbness, tingling, or atrophy on the same side. “Inability to lift fingers” suggests motor weakness, possibly mimicking wrist/finger drop from nerve compression.47

Pancoast syndrome encompasses shoulder/arm pain, brachial plexus deficits (weakness in the arm/hand), and sometimes Horner syndrome (ptosis, miosis, anhidrosis) or hoarseness if nerves are involved. Symptoms appear on the ipsilateral side (right here).56

Why in lung cancer?

Apical tumors grow upward and invade the chest wall, brachial plexus, subclavian vessels, sympathetic chain, and nearby nerves rather than causing early respiratory symptoms like cough.61

This is a classic paraneoplastic/local invasion presentation in advanced or locally invasive non-small cell lung cancer (often squamous or adenocarcinoma). Urgent imaging (CT/MRI chest with contrast), nerve studies if needed, and oncology input are required. Staging and biopsy would confirm.

Note: This is educational — not a substitute for clinical evaluation. See the patient’s oncologist/pulmonologist promptly for confirmation and management. Other differentials (metastases, radiation effects if treated, separate neuropathy) are possible but less likely together.