A Case of Lung Cancer in a Patient with Complete Situs Inversus

Abstract

Background. Complete situs inversus is a congenital, autosomal recessive genetic condition with a prevalence of 1 to 2 in 10,000 people. Case reports of lung cancer in patients with complete situs inversus are rare. Case. A 76-year-old male with complete situs inversus was referred to our hospital due to an abnormal shadow on a chest X-ray. Chest CT revealed a nodule measuring 2.5 cm in diameter in the right lower lobe and complete situs inversus. Because we were unable to obtain a definitive diagnosis using a bronchoscopic approach, video-assisted thoracic surgery (VATS) aspiration cytology was performed under a preoperative diagnosis of suspicious stage IA lung cancer using a bronchial blocker for differential lung ventilation. We used 3D-CT angiography for the preoperative evaluation of the pulmonary arterial system. The intraoperative diagnosis was non-small cell carcinoma; therefore, we performed VATS right lower lobectomy and nodal dissection. The right lung possessed 2 lobes, and the pulmonary arteries and veins corresponded to the usual left-sided pattern. The final diagnosis was poorly differentiated squamous cell carcinoma, pT1bN0M0. Conclusions. Preoperative 3D-CT angiography is useful for evaluating the pulmonary arterial system and safely performing surgery for complete situs inversus. Bronchial blockers are useful for administering differential lung ventilation in patients with complete situs inversus.