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Weekly Chest CasesArchive of Old Cases

Case No : 490 Date 2007-03-19

  • Courtesy of Eun-Young Kang, M.D., Ok Hee Woo, M.D., Hwan-Seok Yong, M.D. / Korea University Guro Hospital
  • Age/Sex 19 / F
  • Chief ComplaintAsymmetric Breasts
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Poland syndrome
Radiologic Findings
Chest radiograph shows slightly hyperlucent right lung (Fig. 1). CT scan demonstrates absence of the right pectoralis major and minor muscles, and small right breast (Fig. 2,3).
Brief Review
Poland syndrome is a congenital anomaly consisting of aplasia or hypoplasia of pectoralis major muscle with ipsilateral syndactyly. Occasionally other malformations of the anterior chest wall and breast including absence or atrophy of the ipsilateral second to fifth ribs, absence of pectoralis minor muscle, aplasia of the ipsilateral breast or nipple, and simian crease of the affected extremity may be associated. The condition is more frequent among males, and usually occurs on the right hemithorax in the unilateral form.

Chest radiography reveals an area of hyperlucency on the affected side that mimics a radical mastectomy or Swyer-James syndrome. CT more clearly depicts the absence of pectoralis major muscle and allows better appreciation of other associated musculoskeletal anomalies.
References
1. Jeung MY, Gangi G, Gasser B, et al. Imaging of Chest Wall Disorders. Radiographics.1999;19:617-637
2. Ferraro GA, Perrotta A, Rossano F, DAndrea F. Poland syndrome: description of an atypical variant. Aesthetic Plast Surg. 2005;29:32-33. Epub 2005 Mar 10.
Keywords
Chest wall, Congenital,

No. of Applicants : 70

▶ Correct Answer : 67/70,  95.7%
  • - NTUH,Taiwan Chang You-Lung
  • - Changi General Hospital, Singapore Angeline Poh
  • - China Medical University Hospital, Taiwan Jun-Jun Yeh
  • - Nirman hi-tech diagnostic centre, mumbai, India Minal Seth
  • - Shree Krishna Hospital, Karamsad, Anand, Gujarat, India N S Harsha Vardhan
  • - Samcheonpo jeil hospital, Korea Su Jin Kang
  • - Inha university hospital, Korea SeungU Choe
  • - Turkey Cetin Celenk
  • - PGIMER, Chandigarh, India Ram Prakash Galwa
  • - Gyengsang National University Hospital, Korea Kim Ji Eun
  • - Samsung Medical Center, Korea DaeKun Oh
  • - Hornu, Belgium Delhaye Delhaye
  • - China Medical University Hospital, Taiwan Sea-Harn Pan
  • - Private hospital in Kerala, India Sarvesh Dubhashi
  • - Jikei University, Japan Shigeki Misumi
  • - CHU Grenoble, France BING Fabrice
  • - Brooklyn, N.Y., USA Naomi Twersky
  • - Gyeonsang National University hospital, Korea Kim Hyeon ok
  • - Hangang Sacred Heart Hospital, Korea Eil Seong Lee
  • - EKH-Berlin, Germany Michael Weber
  • - Clinique Mutualiste ST Etienne, France Odile Wagner
  • - Shin-chon Severanve hospital, Korea Shin Na-young
  • - Cumhuriyet Medical University Hospital, Turkey Burtac Eren
  • - Marein Hospital, Hamm, Germany Davis Chiramel
  • - Severance hospital, Korea Koo Hye Ryoung
  • - Cathay general hospital taipei, Taiwan Chih-Hung Lin
  • - Hospital Sotiria, Athens, Greece Vasilios Tzilas
  • - CHRU Lille hopital calmette, France Toledano Manuel
  • - Severance hospital, Korea Jung-Ho Kang
  • - Shinchon Severance Hospital, Korea Ho-Joon Lee
  • - IRSA LA ROCHELLE, France Jean-Luc BIGOT
  • - Regional Imaging - Riverina, Australia Rashid Hashmi
  • - Kyunghee University Medical Center, Korea Min-Sun Bae
  • - CH annecy, France M'BIENE Stephanie
  • - Vital imaging centre, mumbai, India Ganesh Agrawal
  • - PGIMER Chandigarh, India Praveen Kumar
  • - Annecy hospital, France Gilles Genin
  • - Kyunghee University Medical Center, Korea Su Youn Sim
  • - AIIMS,Delhi, India Ashish Gupta
  • - Ulsan University Hospital, Ulsan, Korea Jong-Chang, Jang
  • - Mackay Memorial Hospital, Taipei, Taiwan Chia-Fu Tsai
  • - Sctimst trivandrum, kerala, India Santhosh Kumar
  • - Ultracare Coimbatore, India Debabrata Das
  • - Apollo clinic, kandivali west, mumbai 400092, India Jeshil R. Shah
  • - Pgims, rohtak, India Keerthiraj Bele
  • - Nanavati hospital, mumbai, India Ajay Kumar Jayaprasad
  • - Balabhai Nanavati hospital, mumbai, India Susheel Kumar
  • - Balabhai Nanavati hospital, mumbai, India Deepak p patkar
  • - Yongsan Hospital, Chung-Ang University, Korea Jae Seung Seo
  • - Mokpo Hankook Hospital, Korea Sanguk Park
  • - IRSA La Rochelle, France Denis Chabassiere
  • - Sweidaa national hospital, Syria Marwan al chami
  • - Chung Moo hospital, Korea Jong Hyeon Mo
  • - Osaka University, Japan Osamu Honda
  • - Yongdong Severance Hospital, Korea Lee Sang Min
  • - Yongdong Severance Hospital, Korea Park Chul Hwan
  • - Institut radiologique mutualiste de la loire, Saint Etienne, France Odile Deglin
  • - EMARTOM Radiology Center, Istanbul, Turkey Ali Elibol
  • - Mackay Memorial Hospital, Taiwan Cheng Kuang-Hua
  • - Dongguk University International Hospital, Korea Hee Seok Choi
  • - Dong-A university hospital, Busan, Korea Park Seong Hoon
  • - Hando general hospital, Korea Ha Young Kim
  • - MAX hospital, NEW DELHI, India VIickrant Malhotra
  • - Polyclinique de SAVOIE, ANNEMASSE, France GAY-DEPASSIER Philippe
  • - Doctors Hospital, Nassau, Bahamas N.B.S.Mani
  • - Anandnagar, Hingne Khurd, Pune, India Bankim J.Amin
  • - E-Da hospital, Taiwan Yu-Feng Wei
▶ Correct Answer as Differential Diagnosis : 2/70,  2.9%
  • - KAUMS, Kashan, Iran Ebrahim Razi
  • - Homs National Hospital, Homs - Syria Rami Abou Zalaf
▶ Semi-Correct Answer : 1/70,  1.4%
  • - Kazipet, Warangal, India Pavankumar Vodithala
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