Venous thoracic outlet syndrome secondary to first rib osteochondroma in a pediatric patient

Osteochondromas account for 30% to 50% of benign osseous tumors and 10% of all bone tumors. Most of these lesions are found incidentally on imaging studies obtained for other reasons. Vascular compromise due to osteochondroma is a rare but well-recognized phenomenon and typically occurs in the lower extremity as a result of a tumor mass projecting into the popliteal fossa. We present the very rare case of a pediatric patient with venous thoracic outlet syndrome due to an osteochondroma of the first rib, and to our knowledge, this report is only the second such occurrence in the medical literature.