Case Report

I have Good News! You don’t have Cancer Cervical Rib Mimicking Supraclavicular Neoplasia

Yusuf Kahya, Bülent Mustafa Yenigün and Ayten Kayı Cangır*
Department of Thoracic Surgery, Ankara University School of Medicine, Ankara, Turkey

*Corresponding author: Ayten Kayı Cangır, Department of Thoracic Surgery, Ankara University School of Medicine, Ibni Sina Hospital, 06100 Sıhhiye, Ankara, Turkey

Published: 20 Nov, 2017
Cite this article as: Kahya Y, Yenigün BM, Cangır AK. I have Good News! You don’t have Cancer Cervical Rib Mimicking Supraclavicular Neoplasia. Clin Surg. 2017; 2: 1746.


Cervical rib; Thoracic outlet syndrome; Supraclavicular neoplasia

Clinical Image

Introduction: Supraclavicular triangle is the neck region where benign/malignant neoplasms, inflammatory and congenital masses are frequently located. In this study, we aimed to present a 19-year-old female patient operated for Cervical Rib (CR) that mimicked supraclavicular neoplasia and leading to Thoracic Outlet Syndrome (TOS).
Case presentation: Thorax CT of the case,which was referred to our department with malignancy in mind and represented as painful, hard, palpable in the form of a mass, located in left supraclavicular area, was reported as: ‘Left CR is articulating with exostosis originating from the 1st left rib. Reported a kink that resulted in >50% narrowing of the subclavian artery due to fibrotic bands extending between the CR and the first rib’ (Figure 1 and 2).With clinical and radiological findings, arterial TOS were diagnosed by scalenotomy+CR resection+excision of fibrotic bands with supraclavicular approach (Figure 3).
Discussion: CR is an extra rib originating from the 7th cervical vertebra. The supraclavicular triangle can be recognised as a rigid and fixed mass by deep palpation . Therefore, supraclavicular triangle may be confused with the neoplasia, as noted in our case [1,2]. It may lead to TOS, in which case surgical resection and/or physical therapy rehabilitation is performed. Keeping CR in mind for the differential diagnosis of supraclavicular mass will protect the patient from unnecessary examination and anxiety of malignancy [3,4].

Figure 1

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Figure 1
Apperence of cervical rib.

Figure 2

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Figure 2
3D reconstruction of thorax CT at the supin position.

Figure 3

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Figure 3
İntraoperative view.


  1. Ang GA, Gerardo LT. Cervical rib mimicking supraclavicular fossa neoplasia. A case report. Acta Cytol. 1994;38(2):271-4.
  2. Chandak S, Kumar A. Usefulness of 3D CT in Diagnosis of Cervical Rib Presenting as Supraclavicular Swelling of Short Duration. J Clin Diagn Res. 2014;8(5):RD01-2.
  3. Chang KZ, Likes K, Davis K, Demos J, Freischlag JA. The significance of cervical ribs in thoracic outlet syndrome. J Vasc Surg. 2013;57(3):771-5.
  4. Tan TW, Kenney R, Farber A. Left arterial thoracic outlet syndrome. Tex Heart Inst J. 2014;41(1):105-6.