Axillary fossa tumours in children : rare and easily missed

Published online: Feb 27 2009

Sandeep Shewale, Roderick Duncan, Dermot Murphy, Milind Ronghe

From the Royal Hospital for Sick Children, Glasgow, Scotland


Three children presenting with pain in the arm and variable neurological signs are described. Each child had several hospital visits before being accurately diagnosed with a soft-tissue sarcoma in the axillary fossa. All presented with increasing pain at rest or on shoulder movement, and with some evidence of neurological dysfunction in the upper limb. Two of the girls had unremitting night pain. Delays in diagnosis of sarcomas are common despite internationally agreed referral guidelines, which are readily accessible. In children with unusual upper limb neurological symptoms, it is essential to have a high index of suspicion, and examine the arm including the axilla, thoroughly, and refer them early for a specialist opinion.