Branching anomaly of the pulmonary ventrobasal and laterobasal arteries from the mediastinal lingular pulmonary artery

The lingular pulmonary artery is known for being frequently subjected to bifurcation anomalies, thus asserting the importance of performing three-dimensional computed tomography angiography before lung surgery for safety reasons. We report a case of branching anomaly of the left ventrobasal and laterobasal arteries, which instead of branching from the interlobar artery, branched as a common trunk from the mediastinal lingular artery. A 68-year-old man with diagnosis of rectal cancer lung metastasis in the ventral segment of left upper lobe (S3) presented branching anomaly of the pulmonary artery, which was detected by a preoperative three-dimensional computed tomography angiography. Although there was a conversion from segmentectomy to left upper lobectomy to secure the margin with the tumor, the operation was safely performed and completed by video-assisted thoracic surgery, since the vascular branching anomalies were characterized preoperatively.