A case of non-small cell lung cancer with coronary artery to bronchial artery anastomosis

Abstract

We report a rare case of lung cancer with coronary artery to bronchial artery anastomosis (CBA). A 73-year-old woman was referred to our hospital because of a 7-mm part-solid nodule in the right lung detected by CT. Because this nodule grew gradually during an about one-year follow-up, we decided to resect it. Angina pectoris was suspected and she underwent coronary angiography and CT angiography at the age of 66. These showed communication between the conus branch of the right coronary artery and right bronchial artery. We started the operation by three-port VATS. Because the nodule was diagnosed as adenocarcinoma by intraoperative frozen section analysis, we decided to perform right S2 segmentectomy. We detected the aberrant networks of bronchial arteries at the hilum caused by CBA, and struggled to stop bleeding from these vessels. As a result, we converted to open thoracotomy and right upper lobectomy. No ischemic ECG change was detected throughout the perioperative period.