Surgical management of a paediatric brachial plexus lipoma

Lipomatous tumours are uncommon in the paediatric population and lipomas arising in the cervical/supraclavicular region are particularly rare. Tumours of this location may affect surrounding vasculature as well as the brachial plexus. Complete surgical excision remains the mainstay of treatment for symptomatic lipomas. Surgery allows for symptomatic relief as well as histological confirmation of the diagnosis, as excluding malignancy is an important component of management in lipomatous tumours. We describe the case of a patient in early childhood who presented with a slowly progressive mass along the neck, clavicle and chest wall, adjacent to the major vessels of the region and encasing the superior aspect of the brachial plexus. Preoperative planning included careful radiographic assessment and neurosurgical evaluation. The patient underwent successful complete resection utilising intraoperative neuromonitoring and early identification and preservation of the brachial plexus. Recovery was uncomplicated and the patient remained neurologically intact.