Misdiagnosis of supraclavicular brachial plexus metastasis as cervical disc herniation - A lung cancer case report

Sep 24, 2026

Uploaded by Ben

Cervical radiculopathy, with an annual incidence of approximately 85 per 100,000 individuals, produces cervical radicular pain but lacks a universally accepted diagnostic gold standard, making accuracy dependent on history, exam, and tests. Brachial plexus metastasis is rare yet clinically important because it can closely mimic common musculoskeletal disorders, delaying recognition in cancer patients. This case report follows a 62-year-old man with prior lung cancer whose supraclavicular brachial plexus metastasis was initially misread as cervical disc herniation.

LanguageEnglish

CategoryHealthcare

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Pages8

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Abstract

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Date received; accepted

Introduction

Case report

Misdiagnosis of supraclavicular brachial plexus metastasis as cervical disc herniation: A lung cancer case report Eun Hwa Jun and So Young Kwon Journal of International Medical Research 2025, Vol. 53(8) 1–8! The Author(s) 2025 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/03000605251370330](DOI: 10.1177/03000605251370330)[ ](DOI: 10.1177/03000605251370330)[journals.sagepub.com/home/imr](journals.sagepub.com/home/imr) Abstract Cervical radiculopathy, with an incidence of approximately 85 per 100,000 individuals annually, is characterized by pain originating from cervical nerve root disruption. Accurate diagnosis is challenging because of the absence of a universally accepted gold standard, necessitating reliance on patient history, clinical examination, and diagnostic tests. Brachial plexus metastasis is a rare but clinically significant condition that can mimic common musculoskeletal disorders, such as cervical radiculopathy. Its nonspecific presentation often results in delayed diagnosis, particularly inpatients with cancer presenting with persistent upper-limb pain. This case report explored the underdiagnosis of supraclavicular brachial plexus metastasis, initially misinterpreted as cervical disc herniation in a 62-year-old man with a history of lung cancer. Despite undergoing cervicalRacz catheter neuroplasty and other treatments, the patient’s persistent right arm pain prompted further investigations. Chest computed tomography and positron emission tomography computed tomography ultimately revealed metastatic squamous cell carcinoma extending to the brachial plexus. This case underscores the critical need for comprehensive diagnostic evaluations and the consideration of metastatic neoplasms in patients with a history of cancer. It also highlights the rarity and clinical significance of brachial plexus metastasis. It emphasizes the importance of an integrated approach to care, addressing both oncological and musculoskeletal issues to improve patient outcomes. Department of Anesthesiology and Pain Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea Corresponding author: So Young Kwon, Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, St. Vincent’s Hospital, 93. Jungbu-Daero, Ji-dong, Paldal-gu, Suwon, Gyeonggi-do, Republic of Korea. Email: [so-young@catholic.ac.kr](so-young@catholic.ac.kr) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)). Keywords Brachial plexus, lung neoplasms, neoplasm metastasis, peripheral nervous system neoplasms, radiculopathy Date received: 14 May 2025; accepted: 4 August 2025 Introduction Cervical radiculopathy, with an annual incidence of approximately 85 per 100,000 individuals, 1 is characterized by pathological disruption affecting the cervical nerve root. This condition arises from encroachment and ensuing inflammation near the cervical neural foramen, causing cervical radicular pain that radiates from the neck to the arm due to irritation of a cervical spinal nerve or its roots. Diagnostic errors occasionally arise when patients present with symptoms suggestive of cervical radiculopathy, as an alternative underlying pathology can mimic this condition.2 Clinical reports and previous studies indicate that brachial plexopathy caused by metastatic disease, although

FAQs

Why is cervical radiculopathy difficult to diagnose accurately?

No universally accepted gold standard exists, so clinicians must rely on patient history, clinical examination, and diagnostic tests.

How can brachial plexus metastasis be mistaken for cervical disc herniation?

Its nonspecific clinical presentation can mimic common musculoskeletal conditions such as cervical radiculopathy or disc herniation, leading to delayed diagnosis.

What ultimately revealed the correct diagnosis in the reported case?

Further investigations including chest computed tomography and positron emission tomography computed tomography identified metastatic squamous cell carcinoma extending to the brachial plexus.

Sep 24, 2026

Uploaded by Ben