An elongated dorsally curved xiphoid process

The xiphoid process of the sternum lies in the epigastric region and functions to serve as an attachment point for vital muscles that aid in respiration. With the xiphoid process extending as the most inferior portion of the sternum, variable morphology is widely observed. During a routine dissection of a 44-year-old Caucasian male cadaver, we discovered a hook-shaped, elongated xiphoid process that protruded dorsally. Potential clinical significance can arise leading to misdiagnosis of the hook-shaped xiphoid process as an epigastric mass during imaging. Though various variations of xiphoid process have been well documented, knowledge of a hook-shaped xiphoid process orientated dorsally remains scarce. Herein, this case study provides clinicians, surgeons, and radiologists a rare anomaly of the xiphoid process in order to further the knowledge of morphological variations of the xiphoid to prevent misdiagnosis and surgical complications.