Extralobar sequestration with a pulmonary arterial feeding vessel.

Area of Science:

• Cardiothoracic Surgery
• Pediatric Surgery
• Thoracic Oncology

Background:

• Extralobar sequestration (ELS) is a rare congenital lung malformation, typically found near the diaphragm.
• ELS usually receives arterial supply from the aorta and venous drainage into the systemic circulation.
• Atypical presentations of ELS, including unusual locations and vascular supply, are infrequently reported.

Observation:

• An 18-year-old woman presented with a chest X-ray abnormality, revealing a non-communicating lung segment between the right upper and lower lobes.
• Three-dimensional reconstruction computed tomography (3D-CT) identified an extralobar sequestration with an unusual feeding artery originating from the pulmonary artery and draining into the pulmonary vein.

Findings:

• The case highlights an extralobar sequestration in an atypical location with a pulmonary arterial feeding vessel, deviating from the usual aortic supply.
• 3D-CT imaging was crucial in delineating the anomalous vasculature, aiding in the diagnosis of this rare congenital lung malformation.

Implications:

• This case underscores the utility of 3D-CT in diagnosing complex congenital lung anomalies like extralobar sequestration.
• Video-assisted thoracic surgery (VATS) presents a viable and potentially minimally invasive surgical option for treating extralobar sequestration, even in atypical presentations.