Poland Syndrome in Neonate as Rare Presentation: Case Report
Monjed Ali *
*Correspondence to: Monjed Ali, SAS Paediatrician, George Eliot Hospital, Nuneaton, UK.
Copyright
© 2026: Monjed Ali. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 12 June 2026
Published: 01 July 2026
DOI: https://doi.org/10.5281/zenodo.21093249
Abstract
Chest wall deformities in neonates are rare and may indicate underlying structural or syndromic pathology. We describe full- term male infants presenting with unilateral anterior chest wall abnormalities in form of left side hypoplastic pectoral muscles, left breast hypoplasia, left 3rd and 4th ribs anomalies and loud heart sounds in right side than left side on examination, with imaging confirming structurally normal heart, consistent with Poland’s syndrome. infant exhibited an isolated left?sided chest wall depression with deformity of the 3rd and 4th ribs but had normal cardiopulmonary function and a structurally normal heart on echocardiography. the baby remained clinically stable without respiratory compromise. This case emphasises the importance of thorough neonatal examination, targeted imaging and early differentiation between syndromic and isolated deformities to guide appropriate counselling and follow?up.
Background
Congenital chest wall deformities encompass a spectrum of anomalies—including pectus excavatum, rib malformations and sternal defects—that may present at birth and range from isolated benign variants to features of complex cardiopulmonary or genetic syndromes. Poland syndrome is a rare congenital condition characterised by unilateral absence or hypoplasia of the pectoralis major muscle, most commonly the sternocostal portion, accompanied by variable ipsilateral upper?limb anomalies; approximately 10% of patients with hand syndactyly exhibit this sequence. First described by Alfred Poland in 1841 (1), the syndrome may also involve hypoplasia or absence of the breast and nipple, rib abnormalities, and, when left?sided, may be associated with dextrocardia. Additional reported associations include oligodactyly, preaxial polydactyly, long?bone defects, scapular anomalies, cranial malformations, gastrointestinal and biliary abnormalities, ureteric anomalies and vertebral segmentation defects(2). Its incidence ranges from 1 in 7,000 to 1 in 100,000 live births(3), with most cases occurring sporadically, though familial autosomal dominant inheritance has been documented(4). The condition is three times more common in males and typically right?sided, making left?sided involvement with ipsilateral preaxial polydactyly of the foot—such as in the present case—an unusual and noteworthy variant(5,6).
Discussion
Congenital chest wall deformities in neonates represent a heterogeneous group of structural anomalies that may range from benign positional variants to features of complex syndromic conditions. Poland syndrome is among the best?described congenital thoracic malformations and is classically characterised by unilateral absence or hypoplasia of the pectoralis major muscle, rib defects, ipsilateral breast or nipple hypoplasia, and upper?limb anomalies such as syndactyly, brachydactyly or oligodactyly(6). More severe presentations may include lung herniation through intercostal defects and, when left?sided, may be associated with dextrocardia(7).
In contrast, the infant in our report who’s A term baby 39 weeks GA, out come of ELCS, born in good condition, on demand breast feeding, Newborn Examination check revealed demonstrated a much milder and more localised pattern of chest wall involvement, characterised by a depressed left upper anterior chest wall and deformity of the 3rd and 4th ribs, but without pectoralis muscle hypoplasia, limb abnormalities, or cardiopulmonary compromise. Chest X-Ray and ECG were normal. Echocardiography confirmed a structurally normal heart in the correct anatomical position, with only a tiny physiological patent foramen ovale. The infant remained clinically stable, fed well, and exhibited no respiratory distress, distinguishing this presentation from the more complex Poland sequence phenotype. The presence of a simple posterior?neck nevus and normal systemic examination further supports an isolated chest wall variant rather than a multisystem syndrome.
Chest X ray: (Images provided with parental consent)
Study of this case highlights the importance of systematic neonatal examination and targeted imaging in evaluating chest wall deformities. While the published Poland syndrome case demonstrates the classical constellation of thoracic and musculoskeletal abnormalities, our infant’s findings align more closely with an isolated congenital rib and chest wall depression, a benign condition that typically requires only observation and parental reassurance. Early differentiation between syndromic and non?syndromic presentations is essential to avoid unnecessary investigations, reduce parental anxiety and ensure appropriate follow?up. The favourable clinical course in our infant reinforces that isolated chest wall deformities with normal cardiopulmonary function generally have an excellent prognosis.
Consent:
Written informed consent was obtained from the parents of the patient for publication of this case report and accompanying images.
References