{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:03:19Z","timestamp":1780095799049,"version":"3.54.0"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The latissimus dorsi (LD) muscle is considered one of the most reliable donor sites for autologous breast reconstruction, particularly in patients with prior oncologic treatment or comorbidities precluding microsurgical options. While its consistent anatomy typically permits straightforward surgical planning, rare anatomical anomalies can dramatically alter intraoperative decision-making. We report the case of a 69-year-old woman with a long oncologic history and multiple comorbidities who underwent delayed breast reconstruction using a pedicled LD flap, 1 year after radical mastectomy and axillary lymphadenectomy. Intraoperatively, the LD muscle was found to be completely absent on the left side, with no identifiable muscle belly and tendon. Immediate adaptation was required, and a serratus anterior muscle flap based on a thoracodorsal branch was used instead. Interestingly, retrospective review of a CT scan performed 2 years earlier for a pulmonary complaint revealed clear evidence of unilateral LD muscle absence, an oversight that underscores the importance of targeted imaging review. This case is one of only four reported in the literature, where unilateral absence of the LD muscle in a non-syndromic patient was encountered, and the only one intraoperative discovery during breast reconstruction. This highlights the critical need for anatomical vigilance and intraoperative adaptability in reconstructive surgery. When standard options fail, familiarity with alternative flaps and sequential planning are essential to achieving functional and aesthetic outcomes.<\/jats:p>","DOI":"10.1055\/a-2820-5151","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:43:59Z","timestamp":1772153039000},"page":"223-226","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Strategies for Unexpected Unilateral Absence of the Latissimus Dorsi Muscle during Breast Reconstruction: A Case Report and Literature Review"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-6985","authenticated-orcid":false,"given":"Matteo","family":"Meroni","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9575-4686","authenticated-orcid":false,"given":"Tania","family":"Panettella","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6647-2196","authenticated-orcid":false,"given":"Elena","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6393-0754","authenticated-orcid":false,"given":"Elmar","family":"Fritsche","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1002\/jso.70059","article-title":"Evolving trends in postmastectomy breast reconstruction with autologous tissues: A large-scale, 24-year retrospective study in China","volume":"132","author":"X Wang","year":"2025","journal-title":"J Surg Oncol"},{"issue":"04","key":"ref2","first-page":"260","article-title":"Latissimus dorsi flap: A winning hand for breast reconstruction salvage","volume":"21","author":"O Friedman","year":"2019","journal-title":"Isr Med Assoc J"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"347","DOI":"10.2214\/ajr.166.2.8553944","article-title":"Poland's syndrome: A mammographic presentation","volume":"166","author":"T H Samuels","year":"1996","journal-title":"AJR Am J 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Seoyoun","year":"2018","journal-title":"Archives of Hand and Microsurgery"},{"issue":"02","key":"ref8","first-page":"175","article-title":"Serratus anterior muscle flap: indications and sequelae. 26 cases and review of the literature","volume":"44","author":"E Fassio","year":"1999","journal-title":"Ann Chir Plast Esthet"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2820-5151.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:48:20Z","timestamp":1780094900000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2820-5151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":8,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2820-5151","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2,26]]},"published":{"date-parts":[[2026,2,26]]}}}