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Gen Thorac Cardiovasc Surg. 2012 Aug;60(8):537-41. doi: 10.1007/s11748-012-0045-z. Epub 2012 May 26.

Two patients of left lung cancer with right aortic arch: review of eight patients.

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Department of Thoracic Surgical Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, Japan.


We report two cases of left lung cancer in patients with variant right aortic arches. Preoperative heart examination ascertained that neither patient had congenital heart disease. Patient 1 exhibited a right aortic arch with mirror-image branching of the major arteries. The patient's clinical stage was T1aN0M0 stage IA. Patient 2 exhibited a right aortic arch with an aberrant left subclavian artery. The patient received induction chemotherapy for cT2aN2M0 stage IIIA adenocarcinoma of the lung. In patients with a right aortic arch undergoing surgery, especially mediastinal lymph node dissection, it is important to consider the anatomical displacement of the vagus and recurrent laryngeal nerves in addition to the vascular abnormalities. In this study, we found that preoperative identification of anomalous structures using three-dimensional computed tomography was particularly useful in evaluating the anatomical location and position of the left recurrent laryngeal nerve from an embryological point of view.

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