Double axillary vein: A case detected by CT

Abstract

CASE REPORT A 50­year­old Japanese woman was presented with right breast cancer with clinically negative axillary nodes. A preoperative contrast­enhanced computed tomography scan showed that the contrast medium admitted flowing in lower part of the right axillary vein, suggesting an anomaly of axillary vein known as double axillary vein (Figure 1). Mastectomy and sentinel lymph node (SLN) biopsy were performed. The intraoperative diagnosis of the axillary SLN was positive for metastasis, and thus additional conventional axillary lymph node dissection was performed. At axillary dissection, a double axillary vein was detected (Figure 2). In this case, the thoracodorsal vein originated from the lower vein (Figure 2, arrowhead). In our case, none of the non­ SLNs was metastatic at final histology. DISCUSSION The axillary vein is the continuation of the basilic vein at the lower border of the teres major muscle. It continues as the subclavian vein at the outer border of the first rib. A few reports describe the variations of axillary veins [1–3], however, variations in axillary CLINICAL IMAGES OPEN ACCESS