Surgical resection of a left lung cancer with attention to the path of blood vessels after induction chemotherapy: Report of a case and review of the literature

Abstract

We describe a case of left lung cancer in a 65-year-old male with a right aortic arch and an aberrant left subclavian artery. The tumor was of the non-small cell type in the left upper lobe, with upper mediastinal lymph node metastases. After induction chemotherapy, we performed a left upper lobectomy accompanied by lymph node dissection. Mediastinal lymph nodes could be dissected easily because the aortic arch was positioned on the right side. On the other hand, we had to pay attention to the pathway of the left recurrent laryngeal nerve and identify lymph node stations in the mediastinum. For safe surgery, preoperative assessment of the pathway of arteries and nerves is very important. In this case, CT scans were applied to anticipate the anatomical position of the left recurrent laryngeal nerve from an embryological point of view. As a result, we were able to perform the surgical operation without difficulty.