Case report demonstrates effective video-assisted lobectomy in a patient with lung cancer, implying the need for detailed imaging to identify vascular anomalies.
Although anatomical variations in pulmonary arterial branching are relatively common, the presence of an anterior truncal basal pulmonary artery is extremely rare. We herein report a unique case of right lower lobe lung cancer associated with an aberrant mediastinal A7 + 8 + 9 + 10(b + c) artery, successfully managed with thoracoscopic right lower lobectomy. A 76-year-old man presented with a gradually enlarging part-solid ground-glass opacity in segment 10 of the right lower lobe, clinically diagnosed as stage cT1aN0M0, stage IA1 adenocarcinoma. Contrast-enhanced imaging was not possible due to an allergy to iodinated contrast; however, high-resolution CT revealed an aberrant basal pulmonary artery that originated from the right main pulmonary artery and coursed medially into the lower lobe. Three-dimensional preoperative reconstruction was limited due to the lack of contrast enhancement. Video-assisted thoracoscopic right lower lobectomy was performed after wedge resection confirmed malignancy. Pathological staging was pT1aN0M0, stage IA1. The patient had an uneventful postoperative course and remains recurrence-free at 1 year. This case highlights the importance of detailed preoperative imaging review, particularly when contrast-enhanced computed tomography is contraindicated. A careful assessment of High-resolution computed tomography in multiple planes and an awareness of radiographic signs are essential for detecting rare vascular anomalies and ensuring safe surgical outcomes.
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Sudo et al. (2025) studied this question.
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