Video-assisted posterolateral fifth intercostal thoracotomy was performed with a small 8-cm incision. Lung function tests revealed a vital capacity of 2.80 L (115.2% predicted), a forced expiratory volume in 1 s (FEV 1) of 2.25 L (113.6% predicted FEV 1), and a diffusing capacity for carbon monoxide of 13.36 ml/min/mmHg (87.3% predicted). Preoperative three-dimensional (3D) CT angiography revealed an aberrant mediastinal A7 arising directly from the right main pulmonary artery, running between the superior and inferior pulmonary veins and entering the right lower lobe (Fig. Thus, she was suspected to have primary lung cancer (cT1bN0M0, stage IA2). No lymph nodes or distant metastases were detected on positron emission tomography/CT. 1) identified on follow-up computed tomography (CT) for oropharyngeal cancer after chemoradiotherapy. Thoracic surgeons need to carefully evaluate CT angiography or enhanced multidetector CT findings at preoperative conferences and always keep this anomaly in mind.Ī 71-year-old woman presented to our department with a slow-growing semi-solid ground-glass nodule in the right lower lobe (S6) (Fig. The lung parenchyma, which was within the fissure due to poor lobulation between the middle and lower lobes, was safely divided. The artery was carefully dissected from the caudal side after inferior pulmonary vein dissection. Intraoperatively, A7 was observed between the superior and inferior pulmonary veins and in the front of the lower bronchus near the anterior hilum. Right lower lobectomy and mediastinal lymph node dissection were performed. Preoperative three-dimensional computed tomography (CT) angiography revealed an aberrant mediastinal A7 in the right main pulmonary artery. We report the case of a 71-year-old woman with an aberrant mediastinal A7 who underwent right lower lobectomy for lung cancer (cT1bN0M0, stage IA2). A mediastinal mediobasal segmental pulmonary artery (A7) from the right main pulmonary artery is extremely rare.
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