Raikos Athanasios, Paraskevas George K, Yusuf Faisal, Kordali Panagiota, Ioannidis Orestis, Brand-Saberi Beate
Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr University, Bochum, Germany.
Ann Plast Surg. 2011 Dec;67(6):646-8. doi: 10.1097/SAP.0b013e31820d688b.
The sternalis muscle is an anatomic variation well known to anatomists, but relatively unknown to clinicians and surgeons. It is localized superficially to the pectoralis major and can cause a diagnostic dilemma during breast surgery, mammography, and computed tomography and magnetic resonance imaging scans, as its appearance mimics tumor pathology of the region. We studied the presence of longitudinally placed muscles in the anterior thoracic wall in 45 cadavers (90 hemithoraces). In an 83-year-old white male, a rare case of crossed-type sternalis was detected on the left side. The muscle originated from the sternal head of the right sternocleidomastoid, crossed into the opposite parasternal half, and split into 2 tendons and 2 muscle bellies that inserted into the left subcostal arch region. This variant was not included in the available sternalis classifications, and an update is suggested. The muscle is of utmost importance and diagnostic value in routine mammogram screening. Moreover, it is of great value for the plastic surgeon, because identification of the variant can aid the differential diagnosis among other regional lesions. Likewise, its superficial location makes it an ideal candidate for utilization as a muscular flap in plastic reconstruction of the head and neck region.
胸骨肌是解剖学家熟知的一种解剖变异，但临床医生和外科医生相对不太了解。它位于胸大肌表面，在乳房手术、乳房X线摄影、计算机断层扫描和磁共振成像扫描期间可能会导致诊断困境，因为其外观类似于该区域的肿瘤病理表现。我们研究了45具尸体（90个半胸腔）前胸壁纵向肌肉的存在情况。在一名83岁白人男性中，左侧发现了罕见的交叉型胸骨肌。该肌肉起源于右侧胸锁乳突肌的胸骨头，穿过对侧胸骨旁半侧，分成2条肌腱和2个肌腹，插入左侧肋下弓区域。这种变异未被纳入现有的胸骨肌分类中，建议进行更新。该肌肉在常规乳房X线筛查中具有至关重要的意义和诊断价值。此外，它对整形外科医生具有很大价值，因为识别这种变异有助于鉴别其他区域病变。同样，其表浅位置使其成为头颈部整形重建中用作肌瓣的理想选择。
