Neurovascular compression by a subpectoral lipoma. A case report of a rare cause of thoracic outlet syndrome.

BACKGROUND Lipomas are benign soft tissue tumours, progressively expanding in volume. Beside frequent aesthetic consequences, lipomas can also exert pressure on surrounding tissues and structures. MATERIALS AND METHODS A case of a subpectoral infraclavicular lipoma compressing the axillo-subclavicular neurovascular bundle, produced unilateral brachialgia, thereby simulating a Thoracic Outlet Syndrome. The expansive, but non-infiltrative, nature of the lipoma allowed local excision in the vicinity of the brachial plexus and infraclavicular vascular structures. RESULTS Surgical removal of the lipoma resulted in complete remission of symptoms in the left arm and hand. CONCLUSIONS In the presence of unilateral brachialgia, a subpectoral tumour causing a Thoracic Outlet Syndrome should always be excluded in the absence of other relevant pathology.