Multiple Concomitant Anatomical Variants Challenging Synchronous Neck and Axillary Lymphadenectomy and Latissimus Dorsi Flap Reconstruction in a Patient with Malignant Melanoma
Bibliographic record
Abstract
The knowledge of anatomy acquired at the university level carries surgeons through most of their careers. However, it is important to be aware of uncommon anatomical variants when performing surgery. The authors describe a case involving three anatomical variants found in three different anatomical locations in a single patient during one operative episode. These included Langer's muscle, transjugular course of the spinal accessory nerve and unusual layout of the femoral vessels at the inguinal ligament. While cadaveric studies report an incidence of up to 7% for the anomaly of the latissimus dorsi muscle, and up to 1% to 3% for a transjugular accessory nerve, clinical experience suggests that it is considerably rarer and can surprise even experienced surgeons. The wary surgeon, having identified one anomaly in their patient, will be mindful that there may be others.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".