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SMJS Volume 3 Issue 1, Page 11-21


Yazan M. Nader Kalou, Muhammad Zia Iqbal, Mazhar Mushtaq

Background: Cervical Rib (CR) is a relatively rare congenital supernumerary structure that arises almost exclusively from the 7th cervical vertebra, either unilaterally or bilaterally.
AIM: To evaluate the association between CR and different types of pediatric neoplasms, focusing
on their embryological origin. Also, reviewing the clinical manifestations of CR and their causality of Thoracic Outlet Syndrome (TOS) among pediatrics and adults.
Materials and Methods: A thorough search through Medline and ScienceDirect databases was conducted to identify relevant studies. Data on the pediatric neoplasms, thoracic outlet syndromes, and their association with CR were extracted from the eligible studies. The resulting studies were filtered down to 43 relevant studies from 88 studies.
Results: The prevalence of CR has ranged from 15.2% in Oceania to 0.8% in Africa. CR was
reported in 2 out of 4 case-control studies to be present in 26.8% of Acute Lymphoblastic Leukemia (ALL) cases in the first study and 12.1% in the second study. Also, 27.4% of patients with a brain tumor had a CR anomaly in the first study compared with 18.2% of astrocytoma patients in the other study. However, there was no significant association between CR and any malignancies in the other studies.
Conclusion: CR may co-occur with pediatric neoplasms such as ALL, neuroblastoma and
Astrocytoma due to the similarity in their abnormal genetic abnormalities. It is believed that over-
Expression or down-expression of certain HOX genes is associated with both pediatric neoplasms
And CR. Thus, CR may be an accompanying sign for specific malignancies. Also, CR is also an
important etiology for non-traumatic TOS giving rise to acute limb ischemia or cerebrovascular

To cite this article: Kalou YM, Iqbal MZ, Mushtaq M. Cervical Ribs: Association With Childhood Neoplasms And Implication In Thoracic Outlet Syndrome. Saudi Med J Students. 2021;2(3): 11-21​. https://www.ut.edu.sa/en/Faculties/Medicine/Pages/Vol-3-Iss-1-SMJS-6057-3007-2021.aspx​