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Background Congenital anomalies are commonly encountered in the craniovertebral junction because of its unique embryologic development. The craniovertebral junction usually comprises the occiput, atlas, and axis. However, malrotation of the atlas (C1) in between the occiput (C0) and axis (C2) with Chiari I malformation as well as unilateral hypertrophy of the atlanto-occipital joint and a lateral mass manifesting features of high cervical myelopathy is a rarely reported anomaly. Case Description A 22-year-old woman presented to us with high cervical compressive myelopathy. Imaging revealed rotation of the C1 vertebra approximately 20° toward the left side with right atlanto-occipital joint dislocation and hypertrophy. Imaging also revealed hypertrophy of a right lateral mass of C1, Chiari I malformation, and right atlantoaxial dislocation exposing the right C2 superior facet. She underwent a right extreme far lateral approach comprising a right C1 posterior arch excision and medialization of the right vertebral artery with excision of the hypertrophied atlanto-occipital joint extradurally and posteromedial excision of the superior articular facet of C1. The patient's compressive myelopathy features improved postoperatively. Conclusions We report the successful management of this rare congenital anomaly and review the literature.

We present a case of congenital unilateral hypertrophy of an upper extremity due to aberrant muscles. Reviewing the previous Japanese reports, we discuss the clinical features and the pathogenetic factors of this rare anomaly.

Unilateral hypertrophy of the lateral mass of the atlas is an extremely rare condition. The authors present a rare type of unilateral atlantal mass hypertrophy with atlanto-occipital fusion which is associated with an invaginated lateral mass of the atlas and the odontoid process into the foramen magnum.A 45-year-old woman presented with a 2-year history of progressive bilateral weakness in the upper and lower extremities and gait disturbance. The left lateral mass of the atlas was hypertrophied and had invaginated into the foramen magnum with the odontoid. The spinal cord was severely compressed at the level of the foramen magnum, surrounded by the lateral mass of the atlas, the odontoid process and the occipital bone.First, ventral decompression was performed using a transmandibular approach. The anterior arch of the atlas, the medial side of the hypertrophied lateral mass and the odontoid process were resected. Two weeks after primary surgery, posterior occipitocervical fusion was performed. The postoperative course of the patient was uneventful. Three years after the operation, she could walk without assistance and her paresthesia improved.To our knowledge, such a case of unilateral atlantal mass hypertrophy associated with atlanto-occipital fusion has not been described previously. The authors discuss the pathology of this case and review the literature on unilateral atlantal mass hypertrophy and associated anomalies of the upper cervical spine.

WOS: 000231783000017, PubMed: 16174509

Actinomycosis is a slowly progressive infection that can occur anywhere in the body. Three distinct clinical entities are described: cervico-facial, abdomino-pelvic and thoracopulmonary. Actinomyces are anaerobic, gram positive, non-acid-fast, branched filamentous bacteria that form part of the normal oral, colonic and vaginal flora of humans. The cervico-facial form of the disease is commonest and results from direct invasion of commensal oral actinomyces into local tissues. The most frequently isolated species is A. israelii. We describe a case where Actinomycosis caused massive unilateral hypertrophy of the tonsil, mimicking neoplasia. This is an unusual presentation of Actinomycosis.

A case of unilateral hypertrophy of the palmaris longus muscle in a girl of thirteen is described, associated with "simian" hands and feet and unusually coarse skin of the trunk. Symptoms of median nerve compression were relieved by excision of the muscle.

A case of a 13-year-old boy who suffered from unilateral hypertrophy of extremities, chest wall and shoulder, and diagnosed as Klippel-Trenaunay-Weber's disease, was reported. The patient terminated in sudden death following rupture of intrasplenic aneurysm. Review of the literature and the entity of this disease were discussed.

These cases are reported to swell the scanty volume of literature on the subject of simple masseter hypertrophy, and to bring to our minds one of the rarer causes of unilateral and bilateral swelling in the side of the face in young men and women. Diagnosis is based on the history; on the absence of trismus and pain and tenderness; on the absence of any palpable mass when the muscle is relaxed; and on the firm immovable bulge when the muscle is contracted, with freely movable skin over it. Unless desired for cosmetic reasons there is little justification for any operative procedure. If cosmetic correction is desired, an operation such as that described by Gurney or Adams would be the treatment of choice.

The question of bilateral asymmetry of the human body has been the subject of numerous investigations and researches on the part of anatomists, anthropologists and archeologists of the past century. As a result of exact measurements taken from a great number of cadavers and living subjects, it has been established that the two halves of the body in the human species, as well as in the higher vertebrates, are in reality never symmetrical. This fact being established, a more detailed study of various asymmetries followed. Meckel 1 was the first anatomist to treat the subject in a scientific manner. Various asymmetries and their physiologic significance were exhaustively treated by von Bardeleben 2 in a paper presented by him before the Anatomische Gesellschaft in 1909. A French investigator, Richard Liebreich, 3 made a most painstaking study of skulls and faces of various races and various periods. In contradistinction to the well-known