Jin HJ, Yu Y, He W, Han Y. Posterior mediastinal extralobar pulmonary sequestration misdiagnosed as a neurogenic tumor: A case report. World J Clin Cases 2022; 10(26): 9340-9347 [PMID: 36159437 DOI: 10.12998/wjcc.v10.i26.9340]
Corresponding Author of This Article
Yun Han, Doctor, MD, PhD, Doctor, Surgeon, Department of Thoracic Surgery, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang 110004, Liaoning Province, China. hany@sj-hospital.org
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2022; 10(26): 9340-9347 Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9340
Posterior mediastinal extralobar pulmonary sequestration misdiagnosed as a neurogenic tumor: A case report
Hong-Jie Jin, Yue Yu, Wei He, Yun Han
Hong-Jie Jin, Yue Yu, Wei He, Yun Han, Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Han Y revised and approved this manuscript; Jin HJ wrote and edited this manuscript; Yu Y assisted with the writing of the manuscript; He W supplied the pictures; all authors contributed to this manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun Han, Doctor, MD, PhD, Doctor, Surgeon, Department of Thoracic Surgery, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang 110004, Liaoning Province, China. hany@sj-hospital.org
Received: March 28, 2022 Peer-review started: March 28, 2022 First decision: May 12, 2022 Revised: May 22, 2022 Accepted: August 6, 2022 Article in press: August 6, 2022 Published online: September 16, 2022
Abstract
BACKGROUND
Pulmonary sequestration-both intralobar and extralobar-is a rare congenital developmental malformation. Extralobar pulmonary sequestrations (EPS) have their own pleura but are separated from the bronchus and usually occur in the left lung. They are mainly found mainly between the lower lobe and the mediastinum. EPS is rarely found within the mediastinum itself, even rarer so in the posterior mediastinum.
CASE SUMMARY
We report the case of a 27-year-old man who was misdiagnosed with a neurogenic tumor based on preoperative contrast-enhanced computed tomography (CT) and magnetic resonance imaging findings. Contrast-enhanced chest CT revealed a posterior mediastinal mass measuring 1.2 cm × 1.4 cm × 3.3 cm, which consisted of some cystic areas and showed slight enhancement. The mass was in the 11th paravertebral region and attached to the 11th thoracic vertebra behind the descending aorta in the posterior mediastinum. An arteriole originating from the intercostal artery and a vein originating directly from the hemiazygos vein were found in the pedicle of the mass. The mass was resected in a uniport video-assisted thoracoscopic surgery. During the operation, the pyramid-shaped mass appeared well-encapsulated. Postoperative histopathology established a diagnosis of EPS. One month later, a follow-up CT of the thorax showed good recovery.
CONCLUSION
Although EPS rarely occurs in the posterior mediastinum, its diagnosis should be considered when posterior mediastinal tumors are suspected.
Core Tip: Extralobar pulmonary sequestration (EPS) usually occurs in the left lung, mainly between the lower lobe and the diaphragm. As EPS occurrence is rare, symptoms have not been sufficiently established and clinicians lack experience in diagnosing and treating EPS; thus, the condition can be easily missed or misdiagnosed. Traditional surgery is the most appropriate approach for the management of EPS. Although interventional therapy may be used in certain cases, it cannot replace traditional surgery as a viable alternative. Indications should be considered individually for each patient before choosing the intervention. Three-dimensional imaging reconstruction may aid clinicians in diagnosing difficult cases.
