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Our institution received a referral for an 82-year-old man with a 27-mm solid nodule in the right upper lobe of the lung on computed tomography. We also detected a supernumerary tracheal bronchus branching from the right wall of the trachea, which was distributed in the right apical segment. The apical segment, the posterior segment, and the anterior segment branches originated from the right upper bronchus, with no regional bronchial defect noted. A squamous cell carcinoma was revealed by the transbronchial biopsy of the lung nodule. Subsequently, we performed video-assisted thoracoscopic right upper lobectomy and lymph node dissection. During the procedure, we safely transected the tracheal bronchus, which branched into the right upper lobe of the lung at the inferior margin of the azygos vein, using a stapler. The incidence of the "supernumerary type" tracheal bronchus is relatively rare compared to the "displaced type," and the coincidence of aberrant vascular structures has also been reported. Thoracic surgeons should consider these anatomical variations when planning surgical procedures.
Uematsu et al. (2024) studied this question.