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Vol. 58. Issue 3.
Pages 260 (March 2022)
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Vol. 58. Issue 3.
Pages 260 (March 2022)
Clinical Image
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Double Aortic Arch and a Coexistent Azygos Lobe
Arco aórtico doble coexistente con un lóbulo de la vena ácigos
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Guoqing Zhanga, Hui Mab, Jindong Lia,
Corresponding author
13598820589@163.com

Corresponding author.
a Department of Thoracic Surgery and Lung Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
b Department of Respiratory Disease, People's Hospital of Zhengzhou, Zhengzhou, Henan Province, China
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A 66-year-old man was admitted with repeated dysphagia. Gastroscopy confirmed the diagnosis of esophageal cancer. Potential metastasis was ruled out in an enhanced CT scan of chest and abdomen. However, 2 rare malformations were found: double aortic arch (DAA) and an accessory fissure of the azygos vein, as shown in Fig. 1. The DAA forms a vascular ring, which encircles trachea and esophagus. It is known to cause respiratory symptoms and dysphagia. A DAA is a rare type of congenital aortic arch anomaly, affecting approximately 0.005–0.007% of fetuses. Azygos lobe is a rare anatomic variant of right upper lobe seen in about 0.4% of population radiologically. Esophageal cancer in an adult, with DAA and a coexistent azygos lobe has not been reported. Awareness of this type of malformation is crucial in the surgical planning of esophagectomy.1,2

Fig. 1.

Images A, B, E and F show the existence of the double aortic arch (red arrow). Images C and D show the azygos vein (blue arrow) and the azygos fissure (asterisk).

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References
[1]
N.A. Kumar, N. Usman, K. Rajan, Y.K. Gaude.
Esophageal cancer and double aortic arch: right-sided thoracoscopic esophagectomy and reconstruction.
J Gastrointest Cancer, 52 (2021), pp. 355-358
[2]
H. Fujiwara, T. Sato, N. Okada, T. Fujita, T. Kojima, H. Daiko.
Thoracoscopic esophagectomy with three-field lymphadenectomy for thoracic esophageal cancer in a patient with a double aortic arch: a report of a case.
Surg Case Rep, 5 (2019), pp. 80
Copyright © 2021. SEPAR
Archivos de Bronconeumología

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