Case Report: An Exploration of Cadaveric Anatomical Anomalies

Abstract

In the gross anatomy laboratory at the Tulane University School of Medicine, our group of six Anatomy Master’s Degree students observed several anatomical and pathological findings in a female cadaver. The dissectors were provided with dissection equipment including forceps, hemostats, blunt probes, and scalpels to study the cadaver. Some notable discoveries included severe scoliosis, an ossified lumbar mass, extensive abdominal adhesions, a duodenal stent, a biliary stent, a hysterectomy and oophorectomy procedure, and medical devices such as a subclavian chemotherapy port and ureteral stents. The scoliosis appeared to be caused by the ossified mass spanning the length of her lumbar spine. Histopathological analysis revealed osteoid tissue which indicated a possible diagnosis of osteosarcoma. The subclavian chemotherapy port was found in the supine position within the right superior thoracic region, leading us to speculate a malignant nature of the lumbar mass. During abdominal dissection, reflection of the anterior abdominal wall was difficult due to the many abdominal adhesions found throughout the peritoneal cavity. The greater omentum was unable to be observed due to the adhesions.  Dissection of the intraperitoneal organs revealed abnormal coloration of the gallbladder and cystic duct. After identifying the organs of the gastrointestinal tract with multiple intestinal adhesions, a duodenal stent was revealed in the descending duodenum. A second stent was identified in the bile duct, suggesting that it had been placed to alleviate biliary obstruction or pancreatitis due to complications of the duodenal stent placement. During the pelvic cavity dissection, the dissectors noticed a complete hysterectomy and oophorectomy. It is unknown whether the procedure was done to prevent further complications in the treatment of the lumbar mass, or if it was done prior to the formation of the lumbar mass. Dissection of the retroperitoneal space revealed that both kidneys had no anatomical variations, but ureteral stents were found in the renal pelvises of both kidneys. The ureteral stents traveled through the ureters and entered into the urinary bladder. Using literature review, the dissectors explored possible links between these findings.