2010 Volume 24 Issue 4 Pages 704-709
An 81-year-old man was referred to our hospital for an abnormal shadow found on a chest radiograph. Chest computed tomography revealed a nodular shadow in the left upper lobe. Bronchoscopic examination revealed abnormal broncheal mucosa limited to within the right intermediate bronchus, and the squamous cell carcinoma was resected. Double primary lung cancer was suspected, and left upper lobectomy was performed. Intraoperatively, it was shown that the superior pulmonary vein did not drain into the left atrium but the left brachiocephalic vein. The anomalous vein was ligated and the left upper lobe was resected uneventfully. The post-operative diagnosis of the left lung tumor was adenocarcinoma. Radiation therapy was performed for the right lung cancer. PAPVC is a congenital anomaly in which parts of the pulmonary vein drain into the right atrium or its tributaries. When the anomaly exists in the residual lung, the loss of the lung with normal blood flow possibly induces post-operative right heart dysfunction. Therefore, chest surgeons should be fully aware of this rare anomaly.
