Case Report: An extremely rare case of double extralobar pulmonary sequestration with anomalous supplying arteries originating from the abdominal aorta in the left thoracic cavity

Abstract

To the best of our knowledge, double or multiple extralobar pulmonary sequestrations (PSs) with anomalous arterial supply in the ipsilateral thoracic cavity have rarely been reported before. PS can be divided into two types: intralobar sequestration (ILS) and extralobar sequestration (ELS). We encountered a 5-month-old infant with double ELS in the left thoracic cavity that was incidentally detected during thoracoscopic surgery. Surgical exploration revealed two separate, well-circumscribed abnormal masses in the left thoracic cavity, and the patient was successfully treated using thoracoscopic surgery. Postoperative pathology confirmed that both masses were PS tissues. Accurate preoperative diagnosis using CT alone may be inadequate in this type of case. Therefore, thoracoscopy may be more suitable for diagnosing and treating unusual ELS.

"A Rare Case of Pulmonary Sequestration in a Young Male Patient"

“…However, in cases without severe symptoms, the surgical resection is controversial because there is no clear evidence that the patient has better prognosis. [9,10] The interesting fact of our case is that we have an adult patient without so severe cases of pneumonia during childhood, even absent but with several recent attacks during adulthood. Because of that, there was a debate between us if this patient needs to proceed directly to surgery or it is better to proceed in case of the next relapsing.…”

“…[7] Lung sequestration in extremely rare cases is related with lung malignancies or with presence of two sequestrations in both lungs simultaneously [8,9] and in these cases surgical resection is done immediately. However, in cases without severe symptoms, the surgical resection is controversial because there is no clear evidence that the patient has better prognosis.…”

Presenting a Case of an Extralobar and Extrapleural Pulmonary Sequestration in a Four-Month-Old Infant

“…It receives its blood supply from the systemic circulation with or without a separate venous drainage and comprises 0.15 to 6.4% of all congenital lung malformations [2,3]. It was first described in 1861 by Rokitansky via a fraction theory in which there is a separation of normally developing lung tissue from the rest of the lung during development which subsequently becomes non-functional [4][5][6]. Pryce then described it in 1946 via a traction theory whereby traction on lung tissue by maturing primitive systemic vasculature results in sequestration when an aberrant early interruption of pulmonary arterial development occurs [4,[6][7].…”