The axillopectoral muscle (Langer's axillary arch): a cause of axillary vein obstruction.

The second patient recognized to have high grade intermittent obstruction of the axillary vein due to an anomalous axillopectoral muscle is reported. This relatively common anomalous muscle extends from the latissimus dorsi to the insertion of the pectoralis major and overlies the neurovascular bundle in the axilla. Preoperative recognition of this anomaly appears possible by phlebography, a history of intermittent axillary vein obstruction, loss of the normal axillary concavity, and a market disparity between obvious visual fullness in the axilla and the great difficulty encountered in palpating an axillary mass. Although a correct preoperative diagnosis of the presence of this anomaly has not been made yet, awareness of this entity is important because simple excision of this muscle is curative.