Rectus Sternalis (Sternalis Muscle): A Rare Variant with surgical Importance: A Case Report


Published: 2023-04-08

Page: 9-14

Takutoshi Inoue *

Department of Anatomy, Teikyo University School of Medicine, Tokyo, Japan.

Toru Yamamoto

Division of Dental Anesthesiology, Faculty of Dentistry and Graduate, School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

*Author to whom correspondence should be addressed.


The rectus sternalis is a relatively common anatomical deformity encountered in anatomical practice, occasionally present in humans, and well known to anatomists. This muscle may be incidentally discovered during oral and maxillofacial surgery because myocutaneous flaps (pectoralis major musculocutaneous flap, delto-pectoral flap) in the thoracic region are often utilized for reconstruction after resection of malignant tumors. In this report, we present a case involving an 82-year-old man with large bilateral rectus sternalis. The purpose of presenting this case is to remind us of the importance of anatomical knowledge in all medical procedures. This muscle is longitudinally aligned along the lateral aspect of the sternum and in front of the pectoralis major muscle. Based on its innervation, there is a consensus that the rectus sternalis may be part of the pectoralis major muscle or part of the rectus abdominis muscle. The rectus sternalis is more common in female than in male patients, and it occurs twice as often unilaterally as bilaterally. Furthermore, its incidence is dependent on sex, race, and ethnicity and is particularly high among Asians. It is important for the health care professional to identify this muscle in the early stages of clinical decision-making.

Keywords: Anatomy training body, rectus sternalis (sternalis muscle), oral and maxillofacial surgery, perioperative management

How to Cite

Inoue, T., & Yamamoto, T. (2023). Rectus Sternalis (Sternalis Muscle): A Rare Variant with surgical Importance: A Case Report. Asian Journal of Medical Case Reports, 5(1), 9–14. Retrieved from


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Priyanka Katara, Sangita Chauhan, Rajesh Arora, Pankaj Saini. A Unilateral Rectus Sternalis Muscle: Rare but Normal Anatomical Variant of Anterior Chest Wall Musculature. J Clin Diagn Res. 2013; 7(12):2665–2667.

Aparna Vedapriya K, Dasarapu Priyanka. Bilateral Rectus Sternalis Muscle: An Anatomical Variant of Anterior Chest Wall. Int J Sci and Res. 2019; 8(6):387-390.

Athanasios Raikos, George K Paraskevas, Maria Tzika, Pedro Faustmann, Stefanos Triaridis, Panagiota Kordali, Panagiotis Kitsoulis, Beate Brand-Saberi. Sternalis muscle: an underestimated anterior chest wall anatomical variant. Journal of Cardiothoracic Surgery. 2011; 6:73.

Prakash K. Sasmal, Susanta Meher, Tushar S. Mishra, N. Deep, Prabhas R. Tripathy, Satyajit Rath. Sternalis Muscle: An Unexpected Finding during Mastectomy. Case Reports in Surgery; 2015. Article ID 723198

Jelev L, Georgiev G, Surchev L. The sternalis muscle in the Bulgarian population: classification of sternalis. J Anat. 2001;199:359-363.

Raikos A, Paraskevas GK, Yusuf F, Kordali G, Ioannidis O, Brand-Saberi B. Sternalis muscle A new crossed subtype, classification, and surgical applications. Ann Plast Surg. 2011;67(6):646-648.

Vijaianand M, Sakthivel M, Sheela Grace Jeevamani, Geeta Anasuya D. A Cadaveric study on Rectus Sternalis muscle and its clinical significance in Western part of Tamilnadu state (Kongunadu region). Int J Anat Res. 2021; 9(2.1):7942-7947.

Aguado-Henche S, Clemente de Arriba C and Cristóbal-Aguado S. A Right Sternalis Muscle: Clinical and Surgical Significance. J Human Anat. 2018;2(2): 000126.

Ulku Akyurek, Diana Caragacianu, Mustafa Akyurek. Sternalis is muscle: An anatomic variation and its clinical implications. J Plast Reconstr Aesthet Surg. 2020;73(11):2084-2085.

K Harish, K S. Gopinath. Sternalis muscle: importance in surgery of the breast. Surg Radiol Anat. 2003; 25:311–314.

Gruber L, Martinoli C, Tagliafico AS, Gruber J, Klauser AS. A Rare Case of a Symptomatic Sternalis Muscle: Ultrasonograpy And MRI Correlation. Ultrasound Int Open. 2016;2(4):E140–E141.

Halle Burley, Georgi P. Georgiev, Joe Iwanaga, Aaron S. Dumont,and R. Shane Tubbs. An unusual finding of the pectoralis major muscle: decussation of sternal fibers across the midline. Anat Cell Biol. 2020;53(4):505–508.

NA Rahman, S Das, I Maatoq Sulaiman, KPP Hlaing, F Haji Suhaimi, AA Latiff, F Othman. The sternalis muscle in cadavers: anatomical facts and clinical significance. Clin Ter. 2009;160:129-131.

Virendra Budhiraja, Swati Bansal, Rakhi Rastogi, Shveta Swami, Rimpi Gupta. Sternalis -An Accessory Muscle of Thoracic Wall. Journal of Clinical and Diagnostic Research. 2018;12(8):AD01-AD02.