Subcoracoid Ganglion Cyst in an Adolescent

Abstract

Ganglion cyst of the subcoracoid location around the shoulder is uncommon. Most cysts of the shoulder are described in the adult population. No previous English literature has reported symptomatic cyst of this location in children. Ganglion of the shoulder can produce various symptoms from mechanical compression such as pain, limited motion and neuropathic weakness. A thirteen-year-old patient presented with chronic pain of his coracoid process and limited shoulder motion in forward flexion and rotation. Ultrasound scan demonstrated a cystic mass at the base of the coracoid process. MRI suggested this mass consistent with ganglion cyst on T2-weighted images. No labral pathology was found on MRI and diagnostic arthroscopy. The patient underwent arthroscopic exploration and open excisional biopsy. No associated intra-articular pathology was found. Through a deltopectoral approach, a cystic mass was directly identified and excised at the base of the coracoid process and subsequently. Histology confirmed the diagnosis of a ganglion cyst. Postoperatively the symptoms have resolved with improved function. A rare case of ganglion cyst of the subcoracoid location in this young age group was reported. Chronic shoulder pain with impingement can be from mechanical compression of a ganglion cyst. Complete surgical excision is important to prevent recurrence.