A hard mass in the supraclavicular region should be thoroughly investigated for malignant metastasis, especially in patients who are older than 40 years.1 Careful examination of the head and neck region, thorax, and abdomen is mandatory. Lung cancer arising from the apex, or Pancoast tumor,2 lymphoma, and tuberculosis should all be included in the differential diagnosis. However, a bony hard mass without associated symptoms or risk factors should raise the suspicion of cervical rib.
Imaging Quiz Case 4. Arch Otolaryngol Head Neck Surg. 2000;126(12):1502-1506. doi: