[Right lung cancer with right aortic arch]

Area of Science:

• Cardiology
• Thoracic Surgery
• Radiology

Background:

• Lung cancer screening can detect early-stage disease in asymptomatic individuals.
• A right aortic arch is a rare congenital anomaly that can present with variant intrathoracic vasculature.
• Accurate pre-operative anatomical assessment is crucial for complex thoracic surgeries.

Observation:

• An asymptomatic 63-year-old man presented with a lung mass detected on chest X-ray.
• Further evaluation confirmed primary lung cancer (Rt. S6. adenocarcinoma, cT2N0M0, c-stage IB) in the presence of a right aortic arch.
• Three-dimensional computed tomography (3D-CT) was utilized to meticulously evaluate the detailed vascular anatomy.

Findings:

• A right lower lobectomy and mediastinal lymph node dissection were successfully performed.
• Intraoperative findings revealed no abnormal pulmonary artery or vein anatomy, allowing for a standard surgical approach.
• No metastasis was found in examined lymph nodes, precluding the need for upper mediastinal dissection.

Implications:

• Three-dimensional computed tomography (3D-CT) is a valuable tool for pre-operative planning in lung cancer surgery, especially with vascular anomalies.
• This case highlights the successful surgical management of lung cancer in a patient with a right aortic arch.
• Detailed pre-operative imaging can ensure safe and effective surgical outcomes in complex thoracic cases.