Case report of anomalous venous drainage of the right upper pulmonary lobe

Anomalous venous drainage of the right upper lobe into the superior vena cava is an uncommon anatomical variation, typically diagnosed incidentally. We report the case of a 76-year-old male patient undergoing right upper lobectomy via video-assisted thoracoscopic surgery (VATS) for a primary pulmonary adenocarcinoma, combined with a minimally invasive subtotal esophagectomy for an adenocarcinoma of the gastroesophageal junction. During the thoracic procedure, an anomalous venous drainage of the right upper lobe into the superior vena cava was identified intraoperatively. The patient had no prior respiratory symptoms suggestive of a left-to-right shunt. Surgical management was adapted to account for the vascular anomaly. We discuss anomalous venous drainage of the right upper lobe into the superior vena cava is an uncommon anatomical variation which may pose significant challenges during thoracic surgeries. This case highlights the importance of careful intraoperative assessment of vascular anatomy during thoracic oncologic surgery.