During routine dissection of a fresh-frozen cadaveric specimen, a 44-year-old at death Caucasian male was found to have an elongated and hook-shaped xiphoid process that protruded dorsally (). Measurements were taken using a digital microcaliper (Mitutoyo, Kanagaw, Japan). The measured length, width, and thickness of the xiphoid process were 54.2 mm, 17.1 mm, and 4.6 mm, respectively. Sternal body and manubrium lengths were 83.5 mm and 60.0 mm, respectively. The angle from the sternal body to xiphoid process was 167°. The attachments of the muscles to the sternum, including the xiphoid process, were normal. During extraction of the sternum from the rib cage, the manubrium was slightly fractured but no other anatomical variations were identified.
A 55-year-old male was referred to our clinic by his General Practitioner regarding complaints of his xiphoid process. Apart from routine physical examination no further analysis had been performed by the general practitioner. The patient had been overweight (BMI 30.6 kg/m2) but had recently, in an effort to live a healthier life, lost 17 kg of bodyweight, which resulted in a BMI of 25.6 kg/m2. However, since the weight loss the patient experienced a pain sensation of the xiphoid process. In his daily life, he works as a mechanic who operates heavy machinery and lifts heavy items. Ever since his weight loss he noticed that his xiphoid process was protruding and lifting items started to get bothersome and painful. In this case a computerized tomography (CT) was available (). This chest CT was made in the process of analysing his symptoms. The images show a protruding xyphoid process. A xiphoidectomy was performed. Postoperatively the patient reported no more pain and remained symptom-free during thirty months of follow-up.