Bilateral lingual-facial trunk: anatomic and clinical implications.

Common origin of lingual and facial artery is a relatively frequent anatomic varia-tion. Instead, bilateral lingual-facial trunk has been described only sparsely in the literature. In this report authors describe and analyse a case of bilateral common lingual-facial trunk in the context of its anatomical, clinical and embryological implications. We also describe possible consequences in performance of elective and emergent surgical operations and modification in surgical techniques that should be considered. We believe that surgeons should be suspicious for this variation's existence and keep alternative solutions in their armentarium.

Giacomini vein: thigh extension of the small saphenous vein - report of two cases and review of the literature.

BACKGROUND: Varicose vein surgery is very commonly performed. Also, it is very frequently employed for recurrent disease. The recognition of the normal or variant veins, inducing incompetency, is a prerequisite for effective treatment. The thigh extension of the small saphenous vein, the so-called Giacomini vein, was extensively described in 1873 by Carlo Giacomini in an incidence of 72%. However, such a vein is usually underestimated in classic surgical textbooks. DESCRIPTION OF CASES: We present two cases of Giacomini vein found in two cadavers, dissected for academic purposes in the Department of Anatomy, where the small saphenous vein displayed a thigh extension without terminating into the popliteal vein. In one case Giacomini vein drained into the large saphenous vein, while in the other case the vein divided into two branches, separately draining into the large saphenous vein and the subcutaneous tissue of the gluteal region. CONCLUSION: Due to the fact that Giacomini vein could be incompetent, associated with or without varicose saphenous vein trunks, the vascular surgeon should keep in mind that anatomical entity, to include it in preoperative ultrasound scanning control. Moreover, this vein could be utilized as an autologous graft, when the large saphenous is not available. Hippokratia 2015; 19 (3): 263-265.

Two large processes at the acromial end of a clavicle: a case report.

BACKGROUND/AIM: The present study describes two unusual and large bony processes which were found at the acromial end of a dried human clavicle, due to their rarity and impressive appearance. DESCRIPTION OF THE CASE: At the anterior border of right dried clavicle we noticed a quadrilateral process having an articular surface at its free end, which probably articulated with the humeral head. At the posterior part of the clavicle inferior surface there was a large conoid process, which replaced the conoid tubercle. The conoid process did not appear any articular surface at its free end to be considered as a coracoclavicular joint. CONCLUSION: Although the conoid process of the clavicle may be congenital and usually articulates with the coracoid process of the scapula, in our case the conoid process was acquired and presented a rough and slightly sharp tip, without any joint surface. It was very interesting that the quadrilateral process found at the anterior border of the same clavicle was probably forming an accessory joint between the clavicle and the humeral head.

Complicated axillary lymphadenectomy due to a pectoralis quartus muscle.

During lymphadenectomy in the left axilla of a 38-year-old woman with a 1.4 cm invasive ductal breast carcinoma an accessory muscle was found. Due to the presence of the anomalous muscle the lymphadenectomy was carried out with difficulty through a limited field. Based on its anatomical characteristics, the supernumerary muscle was recognized as the pectoralis quartus. To our knowledge this is the first report of a pectoralis quartus muscle as a surgical finding. The surgeon should be aware of the possible presence of this anomaly as well as its anatomical characteristics in order to avoid any complications.

Fleshy palmaris longus muscle - a cadaveric finding and its clinical significance: a case report.

INTRODUCTION: Palmaris longus variations may include complete agenesis, variation in the location and form of the fleshy portion, aberrancy in attachment, duplication or triplication, accessory tendinous slips, replacing elements of similar form or position. Description of case: An anomalous palmaris longus muscle was found in the right upper extremity of a 63 year-old male cadaver. The muscle was totally fleshy without a long insertion tendon. Its origin was normal, the belly was rather broad and long, fusiform at the upper half and unipennate at the lower half of the forearm, and it was toggled into a short and thick tendon. At its insertion the tendon was split forming a second thinner tendon. The thick tendon was inserted into the flexor retinaculum and the thinner one into the palmar aponeurosis. The muscle compressed the median nerve although no related symptoms were reported on the cadaver's medical history. DISCUSSION: This variation is of clinical importance because it may cause carpal tunnel syndrome or difficulties in image interpretation by radiologists. In addition the palmaris longus muscle is an anatomical landmark for operations at the forearm and wrist and its tendon can be used as a graft.

A bicarotid trunk in association with an aberrant right subclavian artery. Report of two cases, clinical impact, and review of the literature.

A combination of an aberrant right subclavian artery (ARSA) and a bicarotid trunk (BCT) appears in up to 2.5% of the population. The aim of this study is to report the higher total and male incidence of this variation in the literature and to summarise its clinical impact, providing useful knowledge to anatomists, radiologists, cardiologists, and vascular and thoracic surgeons in order to avoid diagnostic pitfalls and therapeutic complications. A total of 72 (43 female and 29 male) Greek Caucasian formalin-embalmed cadavers were studied. The international literature was reviewed along with the dissection archives of the Department of Anatomy from 1986 to 2009. Two male cadavers were found to have an ARSA combined with a BCT (incidence: total 2.78%, males 6.9%, females 0%). Both aortic arches consisted of three branches: (1) the BCT, (2) the left subclavian artery, and (3) the ARSA. The common carotids followed a normal route to the neck; the ARSA passed between the trachea and the oesophagus in the first case and behind the oesophagus in the second case, and was accompanied by a non-recurrent laryngeal nerve. In the second cadaver the ARSA formed a sharp angle (kinking/buckling) on its route to the right arm. The ARSA is associated with several congenital cardiovascular anomalies and some chromosomal and other syndromes. It is occasionaly responsible for causing dysphagia, dyspnoea, or acute ischaemia to the right upper limb, and it may present as a superior mediastinal mass in cases of aneurysm formation.

Axial transformation of the profunda femoris vein: formation, relations and course in a cadaveric specimen.

When the superficial femoral vein is obstructed by thrombosis, the profunda femoris vein provides an important collateral pathway, transforming into the axial vein of the lower limb. When operating on a transformed axial vein, a surgeon should be aware of the formation, the relations and the course of the vein. A precise description of these anatomical features is not feasible on the basis of ultrasound, venographic or surgical study but only from anatomical studies. We present a case of axial transformation of the profunda femoris vein found in a cadaver, focusing on the anatomical features of the transformed axial vein.