Fahmi H. Kakamad, Shakew S. Mohammed, Razan Babarasul Jalal, Azad S. Hattam, Saywan K. Asaad, Abdullah K. Ghafour, Lawand A. Sharif, Huzaifa Hamid Ahmed, Hadeel Adnan Yasseen, Miran I. Hassan, Hiwa S. Namiq, Harun Amanj Ahmed (Author)
Vertebral Mass Mimicking Thoracic Outlet Syndrome: A Case Report with Literature Review
Fahmi H. Kakamad, Shakew S. Mohammed, Razan Babarasul Jalal, Azad S. Hattam, Saywan K. Asaad,...
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.
