Two surgical cases of right squamous cell lung cancer involving the right aortic arch

Abstract

We report two surgical cases of right squamous cell lung cancer involving the right aortic arch. Both of the cases were anomalous in that the aortic arch and the descending aorta ran into the right chest cavity. No other cardiac malformations were found. The first case (case 1) was of pathological stage T3N0M0 stage IIB, where a tumor in the right upper lobe invaded the chest wall directly, with no metastases detected in the lymph nodes or distant organs. The second case (case 2) was a pathological stage T2N2M0 stage IIIA tumor arising from the intermediate bronchus that obstructed the bronchial lumen, resulting in atelectasis of the right middle and lower lobes. The subcarinal nodes were found to be metastatic. In both these surgeries, the right pharyngeal recurrent nerve had branched up from the right vagus nerve and hooked around the right aortic arch. This case report suggests that we should pay close attention to the anatomical displacement of the right recurrent nerve during surgery, as well as associated malformations in perioperative management when treating right-side lung cancer involving the right aorta.