Thoracic outlet syndrome due to cervical rib presenting as supraclavicular mass in a female child

10year old female child presented with swelling in the right side of neck for past 1 month. Examination revealed a hard, fixed swelling of size 4 x 3 cms in right supraclavicular region. X-ray neck showed bilateral cervical rib. Provocation tests including Adsons test, hyperabduction manuever and EAST were positive on right side. Subsequently CT angiogram confirmed right subclavian obstruction on dynamic imaging and the girl was diagnosed to have arterial thoracic outlet syndrome on right side. The child underwent right cervical rib excision and recovered uneventfully.