A rare anatomical variation of the internal jugular vein

The internal jugular vein (IJV) and omohyoid muscle are important surgical landmarks for the oncological neck dissection procedure. In the normal scenario, the IJV runs under the omohyoid muscle. Although many anatomical variations have been described in the literature, the current report concerns a rare case wherein this relationship was reversed, with the IJV passing over the omohyoid muscle. It appears that this anomaly has not been reported previously. The current report discusses how this rare finding was successfully managed during the surgery and focuses on the clinical implications.