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.
Keywords
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
Figure 2
Figure 3
References
- Ang GA, Gerardo LT. Cervical rib mimicking supraclavicular fossa neoplasia. A case report. Acta Cytol. 1994;38(2):271-4.
- 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.
- 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.
- Tan TW, Kenney R, Farber A. Left arterial thoracic outlet syndrome. Tex Heart Inst J. 2014;41(1):105-6.