Primary lung carcinoma with tracheal bronchus treated with uniportal video-assisted thoracoscopic upper lobectomy: a case report

Benedict Dharmaraj,Narasimman Sathiamurthy,Nguk Chai Diong,Narendran Balasubbiah

doi:10.20517/2574-1225.2020.51

Abstract

Tracheal bronchus is a rare, congenital abnormality of the tracheobronchial tree. Majority of patients with tracheal bronchus are asymptomatic. Lung malignancy associated with tracheal bronchus is rare. An asymptomatic 40-year-old female was diagnosed with right upper lobe lung carcinoma. CT thorax revealed a right upper lobe tracheal bronchus. The patient underwent right uniportal video-assisted thoracoscopic (VATS) lobectomy and recovered well. To our knowledge, this is the first reported case of primary lung carcinoma with tracheal bronchus treated with right uniportal VATS upper lobectomy in Malaysia, and the second reported case internationally.

Highlights

Bronchovascular variations exists in the general population but are often only diagnosed pre- or intraoperatively
We present a case of a middle-aged female with right upper lobe carcinoma, tracheal bronchus and other bronchovascular variations, who underwent uniportal video-assisted thoracoscopic (VATS) right upper lobectomy and lymphadenectomy
Tracheal bronchus was first described by Sandifort in 1758[1,2,3]

Summary

INTRODUCTION

Bronchovascular variations exists in the general population but are often only diagnosed pre- or intraoperatively. We present a case of a middle-aged female with right upper lobe carcinoma, tracheal bronchus and other bronchovascular variations, who underwent uniportal video-assisted thoracoscopic (VATS) right upper lobectomy and lymphadenectomy. A 40-year-old female was referred to our Thoracic Surgery unit for right upper lobe carcinoma She initially presented to a primary health care centre with digital clubbing, but no other respiratory symptoms. The patient’s lung function test was acceptable, with a predicted postoperative forced expiratory volume in one second (PPOFEV1) of 81% for right upper lobectomy. Her CT was reviewed in the Thoracic Surgery outpatient clinic, and it was noted that the patient had a right upper lobe bronchus originating from the trachea, a tracheal bronchus [Figure 1B].

DISCUSSION

Findings

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