scholarly journals An aberrant mediastinal mediobasal segmental pulmonary artery in a patient with lung cancer undergoing right lower lobectomy: a case report

2021 ◽  
Author(s):  
Kazuyuki Komori ◽  
Hiroshi Hashimoto ◽  
Kotaro Yoshikawa ◽  
Koji Kameda ◽  
Shinichi Taguchi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Artery ◽  
Ct Angiography ◽  
Multidetector Ct ◽  
Mediastinal Lymph Node ◽  
Pulmonary Veins ◽  
Main Pulmonary Artery ◽  
Lower Lobectomy ◽  
The Right ◽  
Right Lower Lobectomy

Abstract Background A mediastinal mediobasal segmental pulmonary artery (A7) from the right main pulmonary artery is extremely rare. Case presentation: We have reported a case of a 71-year-old woman with aberrant A7 who underwent right lower lobectomy for lung cancer (cT1bN0M0, stage IA2). Preoperative three-dimensional computed tomography (CT) angiography revealed an aberrant mediastinal A7 from the right main pulmonary artery. Right lower lobectomy and mediastinal lymph node dissection were performed. Intraoperatively, A7 was observed between the superior and inferior pulmonary veins, and at the front of the lower bronchus near the anterior hilum. The artery was carefully dissected from the caudal side after dissection of the inferior pulmonary vein. Then, the lung parenchyma, which was within the fissure due to poor lobulation between the middle and lower lobes, was safely divided. Conclusions Thoracic surgeons need to evaluate CT angiography or enhanced multidetector CT carefully at preoperative conferences and always keep this anomaly in mind.

scholarly journals Lung cancer with partial anomalous pulmonary venous connection in a different lobe: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hikaru Watanabe ◽  
Naoki Kanauchi ◽  
Kouhei Abe ◽  
Soumei Matsuo
Keyword(s):  
Lung Cancer ◽  
Pulmonary Veins ◽  
Lower Lobe ◽  
Right Heart ◽  
Lower Lobectomy ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection ◽  
Right Lower Lobectomy ◽  
Circulatory Dynamics

Abstract Background Anomalous pulmonary venous connection (APVC) is a congenital malformation in which the pulmonary veins connect to the systemic venous system but not to the left atrium. APVC can be classified as total or partial (PAPVC). PAPVC is rare among surgical patients with lung cancer, and most cases are detected incidentally during surgery. We herein report a patient with lung cancer in whom PAPVC was diagnosed before surgery, which made it difficult to determine the surgical procedure. Case presentation A 71-year-old man was followed-up as an outpatient after surgery for renal cell carcinoma. Chest computed tomography showed a 22-mm nodule in the right lower lobe and PAPVC in the right upper lobe. He was diagnosed with lung adenocarcinoma (cT1cN0M0 stage IA3) and scheduled for surgery. Preoperative catheterization showed a pulmonary to systemic flow ratio (Qp/Qs) of 1.64 and mean pulmonary artery pressure (MPAP) of 16 mmHg. Surgical repair of PAPVC is indicated when a patient is symptomatic and has a Qp/Qs ≥1.5–2.0. The patient was scheduled for right lower lobectomy, but postoperative worsening of right heart strain was considered. Concomitant PAPVC repair was therefore considered, but he had no atrial septal defect and was asymptomatic; therefore, PAPVC treatment was considered unnecessary. However, we planned to perform concomitant PAPVC repair if his circulatory dynamics worsened during surgery or if his MPAP exceeded 25 mmHg. His MPAP was 20 mmHg and his circulatory dynamics remained stable, and right lower lobectomy was therefore completed. His postoperative course was favorable. Follow-up catheterization at 6 months showed a Qp/Qs of 1.19 and MPAP of 18 mmHg, with no evidence of increased right heart strain. There was no evidence of right heart failure or recurrence of lung cancer at last follow-up at 18 months after surgery. Conclusions We present a case of right lower lung cancer complicated by PAPVC in the right upper lobe. This case suggests that concomitant repair of PAPVC in the right upper lobe may not be necessary when performing right lower lobectomy, although the patient’s Qp/Qs and MPAP should be considered.

Lung cancer with partial anomalous pulmonary venous connection in a different lobe: A case report

2020 ◽  
Author(s):  
Hikaru Watanabe ◽  
Naoki Kanauchi
Keyword(s):  
Lung Cancer ◽  
Pulmonary Veins ◽  
Lower Lobe ◽  
Right Heart ◽  
Lower Lobectomy ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection ◽  
Right Lower Lobectomy ◽  
Circulatory Dynamics

Abstract Background: Anomalous pulmonary venous connection (APVC) is a congenital malformation in which the pulmonary veins connect to the systemic venous system but not to the left atrium. APVC can be classified as total or partial (PAPVC). PAPVC is rare among surgical patients with lung cancer, and most cases are detected incidentally during surgery. We herein report a patient with lung cancer in whom PAPVC was diagnosed before surgery, which made it difficult to determine the surgical procedure.Case presentation: A 71-year-old man was followed-up as an outpatient after surgery for renal cell carcinoma. Chest computed tomography showed a 22-mm nodule in the right lower lobe and PAPVC in the right upper lobe. He was diagnosed with lung adenocarcinoma (cT1cN0M0 stage IA3) and scheduled for surgery. Preoperative catheterization showed a pulmonary to systemic flow ratio (Qp/Qs) of 1.64 and mean pulmonary artery pressure (MPAP) of 16 mmHg. Surgical repair of PAPVC is indicated when a patient is symptomatic and has a Qp/Qs ≥1.5–2.0. The patient was scheduled for right lower lobectomy, but postoperative worsening of right heart strain was considered. Concomitant PAPVC repair was therefore considered, but he had no atrial septal defect and was asymptomatic; therefore, PAPVC treatment was considered unnecessary. However, we planned to perform concomitant PAPVC repair if his circulatory dynamics worsened during surgery or if his MPAP exceeded 25 mmHg. His MPAP was 20 mmHg and his circulatory dynamics remained stable, and right lower lobectomy was therefore completed. His postoperative course was favorable. Follow-up catheterization at 6 months showed a Qp/Qs of 1.19 and MPAP of 18 mmHg, with no evidence of increased right heart strain. There was no evidence of right heart failure or recurrence of lung cancer at last follow-up at 18 months after surgery.Conclusions: We present a case of right lower lung cancer complicated by PAPVC in the right upper lobe. This case suggests that concomitant repair of PAPVC in the right upper lobe may not be necessary when performing right lower lobectomy, although the patient’s Qp/Qs and MPAP should be considered.

Right Lower Lobectomy With Middle Lobe Preservation After Right Upper Lobectomy in Lung Cancer of the Right Lower Lobe

2013 ◽  
Vol 96 (6) ◽  
pp. 2227-2230 ◽  
Author(s):  
Naohiro Taira ◽  
Tsutomu Kawabata ◽  
Atsushi Gabe ◽  
Takaharu Ichi ◽  
Kazuaki Kushi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Lower Lobectomy ◽  
The Right ◽  
Middle Lobe Preservation ◽  
Right Lower Lobectomy

scholarly journals An aberrant mediastinal medial basal segmental pulmonary artery (A7a) in a patient with lung cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoshiaki Takase ◽  
Hiroyoshi Tsubochi ◽  
Ei Yamaki ◽  
Osamu Kawashima
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Accurate Information ◽  
3D Ct ◽  
Lobe Bronchus ◽  
The Right

Abstract Background Mediastinal branching of the A7a from the right main pulmonary artery (PA) is extremely rare. Herein, we report a patient with an aberrant mediastinal A7a who underwent right basal segmentectomy for lung cancer. Case presentation A 73-year-old man was referred to our department for a right lower lobe nodule measuring 18 mm in diameter on computed tomography (CT). Three-dimensional (3D) CT revealed mediastinal A7a branching from the right main PA. As the patient had undergone colectomy for advanced ascending colon cancer, the nodule was suspected to be a metastasis from the colon primary, and thus, basal segmentectomy of the right lung was performed. Intraoperatively, the A7a was observed behind the V4+5 and middle lobe bronchus. The pathological diagnosis was combined small cell carcinoma with an adenocarcinoma component (p-T1cN0M0, stage IA3). The patient subsequently received adjuvant chemotherapy for colon cancer. At 1-year postoperative follow-up, there was no evidence of disease. Conclusion This is the first report describing an aberrant mediastinal A7a branching from the right main PA. It is important to obtain accurate information about variations of the PA using 3D-CT for safe anatomical pulmonary resection.

Lung cancer with retrograde extension into the right main pulmonary artery: Positron emission tomography/computed tomography findings

Surgery ◽  
2018 ◽  
Vol 163 (2) ◽  
pp. 476-477
Author(s):  
Luis Gorospe ◽  
Nicolás Alejandro Almeida-Aróstegui ◽  
Odile Ajuria-Illarramendi ◽  
Gemma María Muñoz-Molina ◽  
María Eugenia Olmedo-García ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Emission Tomography ◽  
Positron Emission ◽  
The Right

scholarly journals Right Upper Lobe Torsion after Right Lower Lobectomy: A Rare and Potentially Life-Threatening Complication

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Takeo Nakada ◽  
Yo Tsukamoto ◽  
Mitsuo Yabe ◽  
Takeyuki Misawa ◽  
Tadashi Akiba ◽  
...  
Keyword(s):  
Mediastinal Lymph Node ◽  
Noninvasive Positive Pressure Ventilation ◽  
Arterial Oxygen ◽  
Positive Pressure ◽  
Bronchial Stenosis ◽  
Eccentric Rotation ◽  
Lung Lobe ◽  
Lower Lobectomy ◽  
The Right ◽  
Right Lower Lobectomy

An 84-year-old woman was referred to our institution with suspected right lung cancer. Subsequently, she underwent thoracoscopic right lower lobectomy without mediastinal lymph node dissection. Postoperatively, she complained of dyspnea and developed arterial oxygen desaturation after 12 h and acute respiratory failure (ARF). An emergency chest computed tomography revealed the right upper bronchial stenosis with hilar peribronchovascular soft tissue edema because the middle lung lobe had been pushed upward and forward and the right upper lung lobe had twisted dorsally. Emergency bronchoscopy revealed severe right upper bronchial stenosis with an eccentric rotation and severe edema. The bronchia stenosis was successfully treated with glucocorticoids and noninvasive positive pressure ventilation for ARF.

scholarly journals How to avoid en masse lobectomy using VATS technique in presence of hilar fibrosis

2021 ◽  
Author(s):  
Dario Amore ◽  
Dino Casazza ◽  
Alessandro Saglia ◽  
Pasquale Imitazione ◽  
Umberto Caterino ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Lower Lobe ◽  
Lower Lobectomy ◽  
Challenging Issue ◽  
Thoracoscopic Lobectomy ◽  
Increased Risk ◽  
The Right ◽  
Segmental Arteries ◽  
Right Lower Lobectomy

Perivascular fibrosis is technically one of the most challenging issue to manage during thoracoscopic lobectomy and it is associated with increased risk of hemorrhagic injury. Here we report a case of thoracoscopic right lower lobectomy performed with individual dissection of segmental arteries due to dense adventitial fibrosis around the right lower lobe pulmonary artery. This approach may be considered as an alternative to the so-called “en masse” lobectomy and a way to avoid conversion to thoracotomy.

scholarly journals Management of a primary cardiac leiomyosarcoma in a young woman

2021 ◽  
Vol 29 (2) ◽  
pp. 267-270
Author(s):  
Mehmet Akif Önalan ◽  
Ahmet Demirkaya ◽  
Kemal Behzatoglu ◽  
Ersin Erek
Keyword(s):  
Pulmonary Veins ◽  
Tumor Resection ◽  
Complete Tumor Resection ◽  
The Right ◽  
Tumor Remnant ◽  
Invasive Techniques ◽  
Right Lower Lobectomy ◽  
Pathological Confirmation ◽  
Complete Tumor

Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.

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