Unilateral levator claviculae muscle mimicking cervical lymph node enlargement in a patient with ameloblastoma

Abstract

We present a case of a 24-year-old man with an ameloblastoma of the mandible, in whom a soft tissue lesion was noted at pre-operative axial computed tomography (CT). This was demonstrated to be a unilateral levator claviculae muscle following multiplanar reformation. The levator claviculae is a relatively uncommon and little reported normal variant. It is of particular importance in head and neck carcinoma where it may be confused radiologically with lymphadenopathy and lead to inappropriate management.

Anatomical relationships of the cleidoatlanticus muscle. Interpretation about its origin

“…Recognition of this is very important, as stated before (Fasel et al 1994;Rudisuli 1995;Ginsberg and Eicher 1999;Rosenheimer et al 2000;Shaw and Connor 2004), since the variant may be found in the course of exploratory surgery of the neck, as in the case indicated by O'Sullivan and Kay (1998), or may provoke an alteration in the morphology of the clavicle (Ruíz-Santiago et al 2001).…”

“…The location of the cleidocervical muscle has been described in various different forms: unilateral left side (Tomo et al 1994;Fasel et al 1994;Rudisuli 1995;Rubinstein et al 1999;Shaw and Connor 2004;Capo and Spinner 2007), unilateral right side (Testut 1894;León et al 1995;Rubinstein et al 1999), and bilateral (Wood 1869;Macalister 1875;Parsons 1898;Nagashima et al 1989;Aiello and Dean 1990;Tomo et al 1994;Rubinstein et al 1999;Rosenheimer et al 2000).…”

“…The aim of the study is to make it better known, particularly the relationships, arrangement and origin, allowing head and neck specialists to recognize it in routine examinations, thus avoiding erroneous diagnoses, to which attention has been drawn (Fasel et al 1994;Rudisuli 1995;Ginsberg and Eicher 1999;Rosenheimer et al 2000;Shaw and Connor 2004).…”

Anatomy of the levator claviculae, with an overview and a literature survey

“…From another standpoint, the levator claviculae has the potential to cause thoracic outlet syndrome, a rare condition that involves compression at the superior thoracic outlet, leading to pain, arm discoloration, and tingling, among other symptoms (Aydoğ et al 2007). As such, it is important for surgeons and radiologists to be aware of this variation (O’Sullivan and Kay 1998; Ruiz Santiago et al 2001; Shaw and Connor 2004). …”

An Intramuscular Lipoma Developing within an Anomalous Cleido-Occipitalis Cervicalis Muscle

“…Cervical muscular anomalies present most commonly as a painless palpable neck mass, or rarely as a hard mass due to protruberance at the musculotendinous insertion onto the clavicle or as thoracic outlet syndrome due to neurovascular compression [6][7][8]. However, the majority of muscular anomalies are asymptomatic, of which a small proportion are detected incidentally during neck dissections or on cross sectional imaging examinations performed for other indications.…”