Uncommon anatomical variation of the origin of the right upper pulmonary vein detected by 3D reconstruction prior to robotic segmentectomy

We report the case of a 65-year-old female, former-smoker with a history of endometrial carcinoma, in whom a 13-mm pulmonary nodule was detected in the right upper lobe highly suggestive of malignancy. Given the tumor size, a robotic apical segmentectomy was planned. Preoperative 3D reconstruction (Laia XR, Arsoft, Salamanca, Spain) revealed the right superior pulmonary vein coursed posterior to the pulmonary artery trunk (Fig. 1A) and anterior to the bronchus intermedius, confirmed during surgery (Fig. 1B). This variant has not been previously described.¹ This case highlights the need for preoperative 3D reconstructions to fully understand the patient's bronchovascular anatomy before surgery.

Figure 1.

A) Posterior view of the 3D reconstruction. RSPV: right superior pulmonary vein. RIPV: right inferior pulmonary vein. B) Intraoperative view of the operative field.

Funding

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Conflict of interests

The authors have no conflicts of interests to declare related either directly or indirectly to the content of this manuscript.