A case of right posterior segment pulmonary vein (V2) flowing into the contralateral upper pulmonary vein in right lower lung cancer

Abstract

A 66-year-old man was found to have an 18-mm nodule in the right lower lobe S9 segment on computed tomography (CT) performed in the first postoperative year following surgery for sigmoid colon cancer, and underwent surgery with the diagnosis of right lower lobe lung cancer (c-T1aN0M0, Stage IA). An anomalous vein in the V2 segment, which ran posterior to the right main bronchus and flowed into the contralateral upper pulmonary vein root, was detected on preoperative 3-dimensional (3D)-CT. Lower right lobectomy and lymph node dissection were performed thoracoscopically. We performed subcarinal lymph node dissection after taping V2, with careful attention to the vasculature. An abnormality of V2 running posterior to the bronchus is relatively rare. We report the case of a safe surgery for a lung cancer patient with an anomalous V2 flowing into the contralateral upper pulmonary vein, supported by preoperative 3D-CT to identify the anatomical relationships between the blood vessel and bronchus.