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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
- Pectoralis major muscle (PMM)
Definitions
- Pectoralis muscle variants: Congenital or developmental variations in pectoralis muscle appearance
- Poland syndrome: Unilateral absence of sternocostal head of PMM
- Ipsilateral breast may be hypoplastic or absent
- ± anomalies of ipsilateral upper limb, including brachydactyly, syndactyly, and ecterodactyly
- Has evolved to include anomalies of musculoskeletal system of chest and upper limb of variable severity
- Chest wall variants: Anomalies in chest wall growth, congenital or acquired
- Haller index (pectus index)
- Transverse diameter of chest divided by AP diameter
- Normal 2.56 (SD 0.35)
- Pectus excavatum (funnel chest)
- Most common congenital chest wall deformity
- Variable depression of sternum and lower costal cartilages; pectus index ≥ 3.25
- Pectus carinatum
- 2nd most common congenital chest wall deformity
- Body of sternum and adjacent costal cartilages protrude, similar to pigeon breast
- Pectus index 1.42-1.98
- Symmetrical chondrogladiolar deformity: Symmetrical protrusion of sternal body and lower costal cartilages; most common
- Asymmetrical chondrogladiolar deformity: Normal cartilage on one side and protrusion on other
- Mixed carinatum and excavatum deformities
- Chondromanubrial deformity: Anterior protrusion of upper chest, including manubrium, 2nd and 3rd costal cartilages
- Haller index (pectus index)
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Carragee EH et al: Poland's syndrome: When there is no breast. Breast J. 23(6):726-730, 2017
- Lee YK et al: US and MR imaging of pectoralis major injuries. Radiographics. 37(1):176-189, 2017
- Cusano AG & Wong MS: Poland's Syndrome. In: Surgery for Chest Wall Deformities. Switzerland: Springer International. 47-69, 2017
- Brochhausen C et al: Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg. 14(6):801-6, 2012
- Huber KM et al: Implications of anomalous pectoralis muscle in reconstructive breast surgery: the oblique pectoralis anterior. Eplasty. 12:e44, 2012
- Stylianos K et al: Muscle abnormalities of the chest in Poland's syndrome: variations and proposal for a classification. Surg Radiol Anat. 34(1):57-63, 2012
- Blanco FC et al: Management of congenital chest wall deformities. Semin Plast Surg. 25(1):107-16, 2011
- Paraskevas GK et al: Bilateral pectoral musculature malformations with concomitant vascular anomaly. Folia Morphol (Warsz). 69(3):187-91, 2010
- Restrepo CS et al: Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29(3):839-59, 2009
- Soni S et al: Anomalous pectoral musculature. Anat Sci Int. 83(4):310-3, 2008
- Creswick HA et al: Family study of the inheritance of pectus excavatum. J Pediatr Surg. 41(10):1699-703, 2006
- Kazama T et al: Prospective evaluation of pectoralis muscle invasion of breast cancer by MR imaging. Breast Cancer. 12(4):312-6, 2005
- Salhab M et al: Pneumothorax after a clinical breast fine-needle aspiration of a lump in a patient with Poland's syndrome. Int Semin Surg Oncol. 2:14, 2005
- Fokin AA et al: Poland's syndrome revisited. Ann Thorac Surg. 74(6):2218-25, 2002
- Morris EA et al: Evaluation of pectoralis major muscle in patients with posterior breast tumors on breast MR images: early experience. Radiology. 214(1):67-72, 2000
- Connell DA et al: Injuries of the pectoralis major muscle: evaluation with MR imaging. Radiology. 210(3):785-91, 1999
- Bavinck JN et al: Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel-Feil, and Möbius anomalies. Am J Med Genet. 23(4):903-18, 1986
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
- Pectoralis major muscle (PMM)
Definitions
- Pectoralis muscle variants: Congenital or developmental variations in pectoralis muscle appearance
- Poland syndrome: Unilateral absence of sternocostal head of PMM
- Ipsilateral breast may be hypoplastic or absent
- ± anomalies of ipsilateral upper limb, including brachydactyly, syndactyly, and ecterodactyly
- Has evolved to include anomalies of musculoskeletal system of chest and upper limb of variable severity
- Chest wall variants: Anomalies in chest wall growth, congenital or acquired
- Haller index (pectus index)
- Transverse diameter of chest divided by AP diameter
- Normal 2.56 (SD 0.35)
- Pectus excavatum (funnel chest)
- Most common congenital chest wall deformity
- Variable depression of sternum and lower costal cartilages; pectus index ≥ 3.25
- Pectus carinatum
- 2nd most common congenital chest wall deformity
- Body of sternum and adjacent costal cartilages protrude, similar to pigeon breast
- Pectus index 1.42-1.98
- Symmetrical chondrogladiolar deformity: Symmetrical protrusion of sternal body and lower costal cartilages; most common
- Asymmetrical chondrogladiolar deformity: Normal cartilage on one side and protrusion on other
- Mixed carinatum and excavatum deformities
- Chondromanubrial deformity: Anterior protrusion of upper chest, including manubrium, 2nd and 3rd costal cartilages
- Haller index (pectus index)
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Carragee EH et al: Poland's syndrome: When there is no breast. Breast J. 23(6):726-730, 2017
- Lee YK et al: US and MR imaging of pectoralis major injuries. Radiographics. 37(1):176-189, 2017
- Cusano AG & Wong MS: Poland's Syndrome. In: Surgery for Chest Wall Deformities. Switzerland: Springer International. 47-69, 2017
- Brochhausen C et al: Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg. 14(6):801-6, 2012
- Huber KM et al: Implications of anomalous pectoralis muscle in reconstructive breast surgery: the oblique pectoralis anterior. Eplasty. 12:e44, 2012
- Stylianos K et al: Muscle abnormalities of the chest in Poland's syndrome: variations and proposal for a classification. Surg Radiol Anat. 34(1):57-63, 2012
- Blanco FC et al: Management of congenital chest wall deformities. Semin Plast Surg. 25(1):107-16, 2011
- Paraskevas GK et al: Bilateral pectoral musculature malformations with concomitant vascular anomaly. Folia Morphol (Warsz). 69(3):187-91, 2010
- Restrepo CS et al: Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29(3):839-59, 2009
- Soni S et al: Anomalous pectoral musculature. Anat Sci Int. 83(4):310-3, 2008
- Creswick HA et al: Family study of the inheritance of pectus excavatum. J Pediatr Surg. 41(10):1699-703, 2006
- Kazama T et al: Prospective evaluation of pectoralis muscle invasion of breast cancer by MR imaging. Breast Cancer. 12(4):312-6, 2005
- Salhab M et al: Pneumothorax after a clinical breast fine-needle aspiration of a lump in a patient with Poland's syndrome. Int Semin Surg Oncol. 2:14, 2005
- Fokin AA et al: Poland's syndrome revisited. Ann Thorac Surg. 74(6):2218-25, 2002
- Morris EA et al: Evaluation of pectoralis major muscle in patients with posterior breast tumors on breast MR images: early experience. Radiology. 214(1):67-72, 2000
- Connell DA et al: Injuries of the pectoralis major muscle: evaluation with MR imaging. Radiology. 210(3):785-91, 1999
- Bavinck JN et al: Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel-Feil, and Möbius anomalies. Am J Med Genet. 23(4):903-18, 1986
