Extralobar pulmonary sequestration presenting with torsion in an elderly patient: A case report

Area of Science:

• Thoracic surgery
• Diagnostic imaging
• Gastroenterology

Background:

• Extralobar pulmonary sequestration (EPS) with torsion is exceptionally rare in adults.
• Nonspecific symptoms like abdominal pain can delay diagnosis.
• Timely recognition and treatment are crucial to prevent infarction and complications.

Observation:

• An 83-year-old female presented with severe abdominal pain and mild fever.
• CT revealed a non-enhancing posterior mediastinal mass with pleural effusion.
• Video-assisted thoracoscopic surgery identified a twisted, necrotic mass consistent with EPS with torsion.

Findings:

• EPS with torsion can present with atypical symptoms such as abdominal pain.
• Imaging may show a non-enhancing lesion with a twisted vascular pedicle.
• Surgical resection is the definitive treatment for symptomatic EPS with torsion.

Implications:

• Pulmonary sequestration should be considered in the differential diagnosis of unexplained abdominal pain and posterior mediastinal masses.
• Surgical exploration is valuable for both diagnosis and treatment of this rare condition.
• Early surgical intervention can alleviate symptoms and prevent serious complications.