barw Judi Clinical Journal 3105-4102 2026 08 30 Vertebral Mass Mimicking Thoracic Outlet Syndrome: A Case Report with Literature Review 10.70955/JCJ.2026.09 eng Fahmi H. Kakamad Department of Thoracic and Vascular Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. Shakew S. Mohammed Department of Neurosurgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Razan Babarasul Jalal Department of Radiology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Azad S. Hattam Department of Neurosurgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Saywan K. Asaad Department of Orthopedic Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq Abdullah K. Ghafour Department of Orthopedic Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq Lawand A. Sharif Department of Orthopedic Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq Huzaifa Hamid Ahmed Department of Orthopedic Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq Hadeel A. Yasseen Department of Pathology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. Miran I. Hassan Department of Scientific Affairs, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq Hiwa S. Namiq Department of Neurophysiology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Harun Amanj Ahmed Department of Thoracic and Vascular Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq 2026 08 08 Introduction: Neurogenic thoracic outlet syndrome is the most common subtype of thoracic outlet syndrome and can be readily mimicked and misdiagnosed. This report presents a rare cervical vertebral lesion mimicking neurogenic thoracic outlet syndrome, highlighting an important diagnostic pitfall. Case presentation: Presenting with two years of left shoulder pain and immobility following heavy labor, a 17-year-old male underwent provocative testing and nerve conduction studies suggesting left neurogenic thoracic outlet syndrome. Despite improvement with physiotherapy, imaging revealed an expansile lytic mass at the C7 level, measuring 55 × 36 × 32 mm.  Biopsy favored chondromyxoid fibroma. Surgical excision was decided, and the patient was lost to follow-up. Literature review: Five cases of cervicothoracic lesions presenting as thoracic outlet syndrome were reviewed, three of which were female. Pain and paresthesia were the most common symptoms, and the neurogenic subtype predominated. Most lesions arose from the first rib, and histology varied, including aneurysmal bone cyst, osteoblastoma, chondrosarcoma, and hydatid cyst. All patients underwent surgical excision, with symptom resolution or improvement. Conclusion: Cervical vertebral lesions can mimic neurogenic thoracic outlet syndrome, highlighting the importance of imaging in identifying underlying structural pathology.