MyMedR

An unusually medial axillary arch muscle

Dharap A

J Anat, 1994 Jun;184 ( Pt 3):639-41.

In the left upper limb of an adult male cadaver a triangular muscular slip, 3.5 cm long and 2.5 cm wide, arose from the lower border of latissimus dorsi just proximal to its tendon of insertion. It was inserted by a slender 6 cm long tendon mainly into the coracoid process of the scapula. Three short fibrous strands radiated from this slender tendon to gain attachments to pectoralis minor and the common tendon of origin of the short head of biceps brachii and coracobrachialis. In addition 2 flat tendinous bands attached the margin of this muscular slip to teres major. The thoracodorsal nerve entered the main bulk of latissimus dorsi close to the muscular slip but did not supply a separate branch to the latter. This is an axillary arch muscle in an unusually medial location.

Matched MeSH terms: Axilla/anatomy & histology*

Feasibility analysis of treating breast cancer patients with breast-conserving surgery via a periareolar incision combined with non-lipolytic suspension-type mastoscopy

Liu J, He G, Zhang Y, Wong MP, Chu J, Kong L, et al.

Sci Rep, 2023 Jul 26;13(1):12129.

PMID: 37495629 DOI: 10.1038/s41598-023-39199-y

The purpose is to analyze and compare postoperative recovery and complication incidence between a periareolar incision combined with Suspension-type Mastoscopic Axillary Lymph Node Dissection (SMALND) and traditional inflated Mastoscopic Axillary Lymph Node Dissection (MALND). This was a randomized trial conducted from June 1, 2020, to April 30, 2022, in the Department of Second Breast Surgery, Shengjing Hospital of China Medical University, and the Department of Thyroid and Breast Surgery, Zibo Central Hospital, in accordance with the criteria of inclusion and exclusion. Overall, 126 patients diagnosed and treated for early-stage breast cancer were selected to undergo periareolar-incision breast-conserving surgery. Those patients who underwent periareolar-incision surgery combined with SMALND formed the observation group (SMALND Group), while those who underwent periareolar-incision surgery combined with traditional inflation became MALND Group. In the two groups, paired data "t" was used to examine, analyze, and compare the postoperative daily drainage volume and drain removal time, while paired data "χ2" was used to examine, analyze, and compare the incidences of postoperative upper limb edema and paresthesia. There were 64 cases in the SMALND Group and 62 cases in the MALND Group. Between the two clusters, no differences were found in age, clinical staging, BMI, and breast cancer classification (P > 0.05). The intraoperative surgery time of the SMALND Group was 43.37 ± 6.27 min while that of the MALND Group was longer: 45.72 ± 4.25 min (P

Matched MeSH terms: Axilla/pathology; Axilla/surgery

Fulltext Chylous leakage post mastectomy and axillary clearance: clinical aspect, causes and review of literature

Chan AC, Sarojah A

Med J Malaysia, 2013 Jun;68(3):262-3.

PMID: 23749019 MyJurnal

Chylous leakage after mastectomy & axillary clearance is a rare complication. The incidence is less than 0.5%. Anatomical variations in the termination of thoracic duct can occur, rendering it susceptible to injury during axillary dissection. Most chyle leaks in the axilla are managed through conservative measures. Surgical intervention is required in high output chylous leaks. We encountered a case of chylous leak post mastectomy with axillary clearance, which was successfully treated conservatively.

Matched MeSH terms: Axilla*

A rare penetrating injury through the axilla caused by stilt pole in a Bajau Laut boy

Atan AA, Chong JS, Oon ZS, Abu Bakar I

Med J Malaysia, 2020 09;75(5):597-599.

PMID: 32918436

An 8-year-old child of Bajau Laut descent (a stateless tribe in Eastern Borneo and the Sulu archipelago) presented following a fall, with penetrating injury through the axilla caused by a stilt pole, exiting at the supero-anterior aspect of the left shoulder. Due to the lack of comprehension of modern medical treatment and poor language skills, the parents refused to consent for detailed radioimaging studies, nor surgical removal and exploration in the operating theatre. The removal of retained stilt pole was done in casualty area in Hospital Tawau, followed by local exploration under sedation and local analgesia. Despite the horrific injury, there was no limb-threatening neurovascular injury sustained. Management of such injury in the nomadic Bajau Laut population provides valuable insight and about the challenges and decisions of management.

Matched MeSH terms: Axilla/injuries*

The axillary arch - morphological and histological study with clinical importance

Omar N, Abidin FZ, Das S, Abd Ghafar N, Haji Suhaimi F, Abd Latiff A, et al.

Morphologie, 2010 May;94(305):36-9.

PMID: 20359930 DOI: 10.1016/j.morpho.2010.03.001

The latissimus dorsi is a muscle of the back which forms the posterior fold of the axilla and its tendon twists to insert into the floor of the intertubercular sulcus of the humerus. Occasionally, the muscle has a muscular slip which crosses the axilla to insert into the pectoralis major. This muscular slip is often termed as "axillary arch." In the present study, we report bilateral axillary arch detected in a 45-year-old male cadaver. The average vertical length of the axillary arch measured 7 cm. The average maximum width of the uppermost, middle and lower part of the arch measured 2, 3.5 and 3.2 cm, respectively. The presence of the axillary arch is an uncommon finding in humans, considering the fact that it is solely found in the animals who prefer to hang on the trees. A histological study of the axillary arch was also performed and it showed skeletal muscle fibres which was uniformly arranged. The presence of the axillary arch may assist in the adduction of the shoulder. It may also compress the axillary vessels and nerves thereby causing resultant symptoms. Prior anatomical knowledge of the presence of axillary arch may be helpful for surgeons performing radical dissection of the axillary lymph nodes and ligation of axillary vessels, clinicians diagnosing abduction syndromes and interventional radiologists interpreting axillary mass in day to day clinical practice.

Matched MeSH terms: Axilla/anatomy & histology*; Axilla/innervation; Axilla/surgery

Fulltext Anterior shoulder dislocation with axillary artery and nerve injury

Razif MAM, Rajasingam V

Med J Malaysia, 2002 Dec;57(4):496-8.

PMID: 12733178

We report a rare case of left axillary artery injury associated with anterior dislocation of the left shoulder in a 25 yrs old male as a result of a road traffic accident. The shoulder dislocation was reduced. A left upper limb angiogram showed an obstructed left axillary artery. The obstructed segment was surgically reconstructed with a Dacron graft. Six months post operation in follow up, he was found to have good left shoulder function and no neurovascular deficit. This is an injury that could have been easily missed without a simple clinical examination.

Matched MeSH terms: Axilla/injuries*; Axilla/innervation*; Axilla/surgery; Axillary Artery/injuries*; Axillary Artery/surgery

A Single Posterolateral Scapular Approach to Drain Post-Traumatic Intramuscular Scapular and Axillary Abscess in an Adolescent: A Case Report

Khaw YC, Faisham WI

Malays Orthop J, 2019 Jul;13(2):56-58.

PMID: 31467655 DOI: 10.5704/MOJ.1907.012

Scapular abscess is a rare clinical diagnosis. This is a report of an atypical case of extensive intramuscular scapular abscess involving the anterior and posterior aspects of the scapula with extension into the axillary region following minor trauma in a young healthy adolescent, describing a single posterolateral approach to the scapula to evacuate the abscess. Following surgical drainage and antibiotic treatment, patient recovered without any complication.

Matched MeSH terms: Axilla

Eccrine spiradenoma: an uncommon breast tumour

Norly, S., Ros’aini, P., Lim, H.C.

Journal of Surgical Academia, 2012;2(2):33-34.

MyJurnal

Eccrine spiradenoma is a benign tumour of the sweat gland. Eccrine glands can be found almost everywhere but are mostly concentrated on the palms, soles and the axillae. Lesions involving the breast are rare. We present a case of a 13-years-old Malay girl with eccrine spiradenoma of the breast. The clinical presentation and histological features are being described.

Matched MeSH terms: Axilla

Fulltext Hodgkin lymphoma mimicking a large soft tissue sarcoma of the shoulder: the essential role of immunohistochemistry in histopathological diagnosis

Zainal Abidin I, Zulkarnaen AN, Dk Norlida AO, Wai Hoong C, Huong Ling L

Malays J Med Sci, 2012 Oct;19(4):72-6.

PMID: 23613651 MyJurnal

The shoulder and axillary regions contain various complex anatomical structures in close proximity, many of which can give rise to neoplasms. Determining the origin and hence the exact diagnosis of advanced (diffuse) tumours in this region may become problematic. In view of the tumour morphology and the affected location in this case, we highlighted the importance of Hodgkin lymphoma immunohistochemistry interpretation in a tumour which was initially suspected to be a soft tissue sarcoma.

Matched MeSH terms: Axilla

Fulltext Medial pectoral pedicle is a reliable landmark for axillary lymph node dissection

Aripin YM, Ibrahim N, Muhammad R

Asian J Surg, 2013 Oct;36(4):150-3.

PMID: 23726827 DOI: 10.1016/j.asjsur.2013.04.008

The anatomical orientation of structures in the axilla has not been well studied, although it is essential for a neat and safe dissection. The objective of this study was to determine the relations between neurovascular structures in the axilla as they were encountered during axillary lymph node dissection (ALND) for breast cancer.

Matched MeSH terms: Axilla/anatomy & histology*

Fulltext Potassium aluminium sulphate (Alum) inhibits growth of human axillary malodor-producing skin flora in vitro

Hassanain Al-Talib, Nur Izzati Syamimi Mohd Nasir, Hafizuddin Yaziz, Nur Fatihah Zulkafli, Nur Aqidah Adani, Ahmad Ikhwan Noor Rashidi, et al.

Journal of Clinical and Health Sciences, 2016;1:59-63.

Axillary malodor is caused by microbial biotransformation of non-smelling molecules present in apocrine secretions, into volatile odorous molecules. This study aimed to determine the antimicrobial activities of potassium aluminium salts (alum) against four malodor-producing axillary bacterial flora, as an alternative natural product for reducing axillary malodor.

Matched MeSH terms: Axilla

Fulltext Cotton-ball granuloma mimicking axillary lymphadenopathy in a breast cancer patient

Hashim H, Alli K, Faridah Y, Rahmat K

Biomed Imaging Interv J, 2011 07 01;7(3):e19.

PMID: 22279496 MyJurnal DOI: 10.2349/biij.7.3.e19

Foreign body granuloma is a reaction to either a biodegradable substance or inert material. In a breast cancer patient who had undergone an excision or mastectomy with axillary clearance, a foreign body granuloma in the axilla may be misinterpreted as an axillary lymph node. We report our experience with a case of cotton-ball granuloma of the axilla in a breast cancer patient, which mimics a lymph node radiologically from the CT scan, mammogram and ultrasonography. Following biopsy and excision, the mass was diagnosed histologically as a foreign body granuloma.

Matched MeSH terms: Axilla

Fulltext A rare case of retropharyngeal hibernoma

Nazli Z, Norizal MN, Noor Kaslina MK, Abdul Fattah AW

Med J Malaysia, 2015 Apr;70(2):98-9.

PMID: 26162385 MyJurnal

Hibernoma is a slow growing, rare benign tumour, which derived from brown adipose tissue. This tumour is usually found in the area where foetal fat persists such as back, axilla, retro peritoneum and thorax. Hibernoma rarely occurs in the retro pharynx. We report a case of retropharyngeal hibernoma in a 44-year-old male. He presented with obstructive symptoms for six months and a retropharyngeal mass upon examination. His CT scan findings showed a mass in the prevertebral region from level of C2 until C5 causing narrowing of upper aero digestive tract. Histopathological examination reported as hibernoma.

Matched MeSH terms: Axilla

Fulltext A new insular species of skink of the genus Sphenomorphus Strauch 1887 (Squamata: Scincidae) from Pulau Perhentian Besar, Terengganu, Peninsular Malaysia

Grismer, Lee L., Wood, Perry Lee Jr., Grismer, Jesse Leland

Trop Life Sci Res, 2009;20(1):-.

MyJurnal

A new species of small, insular, forest floor skink, Sphenomorphus perhentianensis sp. nov., is described from Pulau Perhentian Besar of the Perhentian Archipelago, Peninsular Malaysia. This species is differentiated from all other 36 Sundaland species of Sphenomorphus based on a unique collection of morphological and colour pattern characteristics. These unique characteristics include a snout-vent length of 30.0 mm, 29 midbody scale rows, smooth as opposed to striated dorsal scales, 65 paravertebrals, 61 ventrals, 4 supraoculars, parietals contacting the posterior-most supraocular, 1 medially projecting superciliary scale, 2 loreals, 6 supralabials and infralabials, 10 lamellae beneath the fourth toe, smooth subdigital lamellae, enlarged preanal scales, no body bands, a dark brown, diffuse, dorsolateral stripe extending to just past the axilla, a cream coloured dorsolateral stripe on the nape and anterior-most portion of the body, and no cream coloured postorbital stripe. The discovery of a second endemic reptile in the Perhentian Archipelago underscores the unrealized biodiversity of its herpetofauna. Additional works will describe two additional species from the Perhentian Archipelago.

Matched MeSH terms: Axilla

Fulltext Radiation induced sarcoma: a risk that is almost forgotten

Ruhi Fadzlyana, J., Nani Harlina, M.L., Saladina Jaszle, J., Rohaizak, M.

Journal of Surgical Academia, 2014;4(1):67-69.

MyJurnal

Radiotherapy has been widely use as an adjuvant therapy in the breast cancer management. The usage has increased the incidence of radiation induce sarcoma. We here present a case of radiation induce sarcoma of the axilla following mastectomy and axillary lymph node dissection for infiltrating ductal carcinoma.

Matched MeSH terms: Axilla

Fulltext Kimura's disease in Malaysian patients : three case reports

Roslan Abdul Rahman, Fadzilah Ismail, Roszalina Ramli, Ghazali Mat Nor, Sha Primuharsa Putra

Jurnal Sains Kesihatan Malaysia, 2005;3(1):1-8.

MyJurnal

Kimura's disease is a chronic inflammatory disorder which affects the subcutaneous tissues of the head and neck, axilla and upper limb as well as the groin region. In the head and neck region, major salivary glands and regional lymph nodes are mainly involved with associated eosinophilia and an elevated IgE concentration. Three cases of Kimura's disease involving the parotid glands, lymph nodes and cheek are presented with a brief review of the literature.

Matched MeSH terms: Axilla

Fulltext Neurothekeoma palpebrae in association with multiple superficial angiomyxomas: Tegumental Angiomyxoma-Neurothekeoma syndrome (TAN syndrome)

Kah TA, Yong KC, Annuar FH

Clin Pract, 2011 Jul 01;1(3):e67.

PMID: 24765328 DOI: 10.4081/cp.2011.e67

We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left upper limb, chest, right axilla, hard palate) and epidermal cyst (chin). The histopathological specimens were negative to S-100 protein antibody. Systemic review and family history was unremarkable. Excision biopsy and upper lid reconstruction were performed. Intraoperatively the tumor was multilobulated, firm, well encapsulated and did not invade the underlying tarsal plate. Histopathological features of the upperlid tumor were consistent with nerves sheath myxoma (neurothekeoma). To the best of the authors' knowledge, this is the first reported case of neurothekeoma in association with multiple superficial angiomyxoma.

Matched MeSH terms: Axilla

Fulltext In the finger it lingers

Mohd AW, Mohamad I, Wan Ghazali WS, Johan KB

Malays Fam Physician, 2017;12(2):32-33.

PMID: 29423129 MyJurnal

A previously healthy 80-year-old woman presented with a history of a thorn prick injury over the
distal phalange of her left finger obtained while gardening two months ago. She claimed to have a
non-healing cut with a nodular lesion, which progressively increased in size, extending upwards
towards the region of her left arm. There was no fever or palpable lymph nodes in the axillary region.
She had been prescribed antibiotics from the local hospital but her condition did not improve.

Matched MeSH terms: Axilla

Haemoblock hemostatic substance in reducing seroma formation post axillary lymph node dissection following breast conserving surgery

Isahak MI, Abdullah MS, Awang RR, Abdul Rashid NF, Md Sikin S, Abdullah Suhaimi SN, et al.

World J Surg, 2024 May;48(5):1159-1166.

PMID: 38578243 DOI: 10.1002/wjs.12134

BACKGROUND: Axillary lymph node dissection (ALND) in breast cancer management, necessitates a nuanced understanding of complications that may impede treatment progression. This study scrutinize the impact of Haemoblock hemostatic solution, evaluation it's potential in reducing seroma complication by controlling lymph flow and obliterating axillary dead space.

METHOD: A prospective, randomized, double-blinded controlled trial was conducted with 58 patients undergoing breast conserving surgery (BCS) and ALND, stratified into two groups: Group A (ALND + Haemoblock, n = 29) and Group B (ALND + placebo, n = 29). Postoperative drainage charts were monitored, with the primary endpoint being the time to drain removal, Additionally, patients were observed for surgical site infection (SSI).

RESULTS: Group A exhibited a marginally higher mean total drain output (398 +/- 205 vs. 326 +/- 198) compared to Group B, this difference did not attain statistical significance (p = 0.176). Equally, the mean time to drain removal demonstrated no discernible distinction between the two groups (6 +/- 3.0 vs. 6 +/- 3.0, Group A vs. Group B, p = 0.526). During follow up, nine patients in Group A required seroma aspiration (mean aspiration 31 +/- 73) as compared to Group B, 6 patients required aspiration (mean aspiration 12 +/- 36), p = 0.222). No notable disparity in SSI rates between the groups was identified.

CONCLUSION: In conclusion, the administration of Haemoblock did not manifest a discernible effect in mitigating seroma production, hastening drain removal, or influencing SSI rates following ALND. The study underscores the intricate and multifactorial nature of seroma formation, suggesting avenues for future research to explore combined interventions and protracted follow-up periods for a more comprehensive understanding.

Matched MeSH terms: Axilla*

Is clinical assessment of the axilla a reliable indicator for lymph node metastases in breast cancer?

Haron NH, Taib NA, Yip CH

ANZ J Surg, 2008 Nov;78(11):943-4.

PMID: 18959689 DOI: 10.1111/j.1445-2197.2008.04709.x

Matched MeSH terms: Axilla

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