Rare Brachial Plexus Tumor: Case Report and Surgical Management Insights from Pakistan

Abstract

A 40-year-old male presented with a six-month history of numbness, paresthesia, and progressive flaccid weakness that was localized to the right C5 dermatome. A large, lobulated, and encapsulated mass in the medial aspect of the right axilla was identified via imaging studies. The mass was associated with the superior and middle trunk of the brachial plexus and extended to the supra and infraclavicular fossa. The imaging studies were supported by the nerve conduction studies (NCS), significantly highlighting the involvement of the right upper trunk with signs of denervation. The transclavicular neurosurgical approach was effective in the removal of the tumor while preserving the normal neurological functions. Brachial plexus tumors are rare and often underdiagnosed due to nonspecific symptoms and overlapping features with other neuromuscular conditions. This case highlights the diagnostic value of MRI and nerve conduction studies in identifying tumor characteristics and planning surgery. A transclavicular approach enabled safe excision with preservation of neural function. Postoperative recovery was favorable, with improved motor and sensory function and no recurrence at two months. This case emphasizes the importance of early diagnosis, appropriate surgical technique, and multidisciplinary management in achieving optimal outcomes. This case report highlights the diagnostic and therapeutic challenges associated with brachial plexus tumors due to their complex anatomical location. However, Imaging studies, a multidisciplinary approach, and nerve conduction studies were important in achieving favorable outcomes. The transclavicular neurosurgical approach was meaningful in tumor excision while preserving normal neurological function.