Invasive Mucinous Adenocarcinoma Combined with Pulmonary Sequestration

Background: It is rare for lung cancer to be associated with pulmonary sequestration.Methods: A 33-year-old man with a history of a lung abscess 8 years ago presented with sputum and was referred for further examination.Chest computed tomography (CT) revealed an emphysematous cyst with a 51 mm44 mm mass in the left S10, adjacent to the aorta.The cysts exhibited contrast enhancement, with aberrant arteries suggesting an abnormal vascular structure.Initially diagnosed with left pulmonary interlobar sequestration or an infected giant cyst, surgery was indicated.Intraoperatively, 2 aberrant arteries arising from the descending aorta were identified, consistent with alveolar fractionation.Results: A 4-port video-assisted left lower lobectomy was performed, and the patient was discharged on the 8th postoperative day.Postoperatively, histopathology revealed the pulmonary cyst to be combined with invasive mucinous adenocarcinoma, measuring 50 mm35 mm.No lymph node metastasis was observed.As the lung cancer was not suspected by preoperatively by CT, a systematic work-up was conducted postoperatively.The patient was diagnosed with T2bN0M0 and stage IIA.He declined postoperative adjuvant chemotherapy and remained recurrence-free for 4 years.Conclusion: Invasive mucinous adenocarcinoma is difficult to diagnose preoperatively due to its diverse clinical feature.Although rare, there have been reports of lung cancer coexisting with pulmonary sequestration.We present this case, discussing relevant previous reports and the unique aspects of the diagnosis.