Thoracoscopic lobectomy for lung cancer in a patient with a partial anomalous pulmonary venous connection: a case report
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CASE REPORT
Open Access
Thoracoscopic lobectomy for lung cancer in a patient with a partial anomalous pulmonary venous connection: a case report Kenji Inafuku1*, Takao Morohoshi1, Hiroyuki Adachi1, Keisuke Koumori1 and Munetaka Masuda2
Abstract Background: A partial anomalous pulmonary venous connection is a rare congenital defect in which blood from the pulmonary vein is returned to the right atrium. Asymptomatic patients with a partial anomalous pulmonary venous connection with a small left-to-right shunt do not require surgical treatment. If such patients require a major lung resection, the surgical procedure could precipitate fetal right heart failure if the anomalous venous connection remains uncorrected. Case presentation: A 59-year-old man was found to have an abnormal shadow on chest roentgenogram. Chest computed tomography imaging showed a mass in the right upper lobe. At the same time, we incidentally found an anomalous vessel. We diagnosed the abnormality as a partial anomalous pulmonary venous connection. Because the mass may have been lung cancer, a right upper lobectomy was performed using video-assisted thoracoscopic surgery. The right upper lobe vein drained into the superior vena cava. The anomaly was not corrected and the surgery was successful. His postoperative course was uneventful without cardiac failure. Conclusions: Before performing a major lung resection, surgeons should be aware of this rare anomaly and carefully interpret clinical images of all pulmonary veins. Keywords: Lung cancer, Partial anomalous pulmonary venous connection, Video-assisted thoracoscopic surgery, Case report
Background A partial anomalous pulmonary venous connection (PAPVC) is a rare congenital defect in which the right atrium is the point of return for blood from the pulmonary vein. This anomaly is often associated with other congenital heart defects, especially atrial septal defects. Asymptomatic patients with a PAPVC with a small left-to-right shunt do not require surgical treatment. However, if patients with PAPVC require a major lung resection, the surgical procedure could precipitate fetal right heart failure if the PAPVC is not corrected [1, 2]. In this article, we present a case of right PAPVC that was diagnosed during preoperative examinations for lung cancer.
* Correspondence: [email protected] 1 Department of General Thoracic Surgery, Yokosuka Kyosai Hospital, 1-16 Yonegahamadori, Yokosuka, Kanagawa 238-8558, Japan Full list of author information is available at the end of the article
Case presentation An abnormal shadow was detected in a 59-year-old man during a routine medical examination. He was asymptomatic and his past history was unremarkable. The chest roentgenogram showed a mass shadow in the right upper lung field. Chest computed tomography (CT) imaging showed a 4.5 cm × 4.0 cm mass in the S1 segment of the right lung (Fig. 1). At the same time, we incidentally found an anomalous vessel. This vessel originated from the right upper lobe and drained into the superior vena cava (SVC) (Fig. 2)
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