Persistent Median Artery With a Reversed Palmaris Longus and Volar Ganglion

Being aware of the variants of upper extremity anatomy is of utmost importance to a surgeon. This case report describes a patient who presented with two separate wrist masses. Operative exploration was planned, and both the structures were investigated. The distal mass was identified as a volar wrist ganglion, and the more proximal mass was identified as the muscle belly of a reversed palmaris longus muscle. Incidentally, it was noted that the patient had a patent, persistent median artery. Although many variants of the palmaris longus have been described, as have been cases of a persistent median artery, both have not been previously documented in a single patient. Although this is rare, having knowledge of possible anatomic variations is valuable for any surgeon operating on the upper extremity.