Unilateral Absence of the Psoas Major and Iliacus Muscles and Downstream Effects of Surgical Intervention in a 96 year-old Female Donor

Nicole  Occidental; Sara Ottinger; Weston Northington; Kimberly O'Brien; Anders Nowell; David Davies; Tiffany  Huitt; Erica Malone

doi:10.61797/ijcsav.v6i1.419

Nicole Occidental College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
Sara Ottinger College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
Weston Northington College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
Kimberly O'Brien College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
Anders Nowell College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
David Davies Division of Clinical Anatomy, Department of Neuroscience, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
Tiffany Huitt Division of Clinical Anatomy, Department of Neuroscience, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA
Erica Malone Division of Clinical Anatomy, Department of Neuroscience, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205, USA

DOI: https://doi.org/10.61797/ijcsav.v6i1.419

Keywords: Donor dissection, Surgical intervention, Quality of life, Muscle atrophy, Scoliosis, Retroperitoneal tumor, Absent iliacus muscle, Absent psoas muscle, Absent iliopsoas muscle

Abstract

Learning anatomy through donor dissection allows students the unique opportunity to explore variations in anatomical structures which may include or indicate pathological anomalies. Findings could reveal insights into the life of the donor, along with the downstream effects of clinical intervention. This case study discusses the findings of a group of first-year medical students during a full body dissection of a 96-year-old female. Among other anomalies, evidence of drastic surgical intervention, extreme scoliosis, and muscle atrophy were noted. Findings suggest that the donor’s right psoas major and iliacus muscles were removed, likely as part of a surgical resection of a retroperitoneal tumor. Distal to the resected muscles, notable muscle atrophy with fat infiltration in the anterior right thigh muscles suggests muscle wasting, which could be secondary to the removal of these muscles. In addition, extreme scoliosis was discovered, likely attributed to the imbalance in hip flexor muscles following surgical removal of the iliopsoas muscle. The theorized surgical removal of iliopsoas muscles along with the downstream effects of muscle atrophy and severe scoliosis depict the impact surgical intervention can have on a patient’s quality of life. Anatomical findings of the donor discovered during dissection and theorized surgical interventions based upon gross findings are discussed in detail within this case.