Abstract
In thoracic surgery, we occasionally encounter vessel anomalies. We herein report an extremely rare surgical case with the absence of the azygos vein. Mediastinal vascular abnormalities are said to be rare. The etiology of vascular abnormalities of the whole body, including the chest is known gene mutations, hormone abnormalities, infection, and trauma. But, many causes have been unknown. In thoracic surgery field, there is some reports and literature about pulmonary arteriovenous malformation, pulmonary sequestration, and partial anomalous pulmonary venous return. But reports about absence of azygos vein are not much. It is considered that it is less likely to become a problem in clinical. As we discussed in the paper, it will be more interesting if the association with PLSVC reveals from more cases. A 58-year-old man was admitted to our hospital in order to undergo operation for the treatment of lung cancer. We detected absence of the azygos vein by preoperative computed tomography (CT). Furthermore, three-dimensional angiography (3D-angiography) showed that the right superior intercostal vein and hemiazygos vein in the left thoracic cavity were more developed than usual. Then, we discuss the key points during surgery and suggest the potential association between the absence of the azygos vein and a persistent left superior vena cava (PLSVC).
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00276-016-1704-z/MediaObjects/276_2016_1704_Fig1_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00276-016-1704-z/MediaObjects/276_2016_1704_Fig2_HTML.jpg)
Similar content being viewed by others
References
Arslan G, Ozkaynak C, Cubuk M, Sindel T, Luleci E (1999) Absence of the azygos vein associated with double superior vena cava: a case report. Angiology 50:81–84
Arslan G, Cubuk M, Ozkaynak C, Sindel T, Luleci E (2000) Absence of the azygos vein. Clin Imaging 3:157–158
Arslan G, Cubuk M, Ozkaynak C (2005) Absence of the azygos vein associated with left superior vena cava. Eur J Radiol Extra 54:15–17. doi:10.1016/j.ejrex-2005-02-004
Bales G (2014) A semi-quantitative approach to variation of the azygos vein course. Clin Anat 27:1030–1037. doi:10.1002/ca.22346
Campbell M, Deuchar DC (1954) The left-sided superior vena cava. Br Heart J 16:423–439
Yazdi Hadi-Rokni, Sotoudeh Houman, Taslimi Reza (2006) Absence of azygos vein in an adult patient with polysplenia syndrome. Eur J Radiol Extra 59:89–92. doi:10.1016/j.ejrex-2006-04-018
Hatfield MK, Vyborny CJ, MacMahon H, Chessare JW (1987) Congenital absence of the azygos vein: a cause for “aortic nipple” enlargement. AJR Am J Roentgenol 149:273–274
Hsu LF, Jaïs P, Keane D, Wharton JM, Deisenhofer I, Hocini M, Shah DC, Sanders P, Scavee C, Weerasooriya R, Clementy J, Haissaguerre M (2004) Atrial fibrillation originating from persistent left superior vena cava. Circulation 7:828–832. doi:10.1161/01.CIR.0000116753.56467.BC
Kullnig P, Melzer G, Hausegger K, Einspieler R (1990) Computed tomographic diagnosis of left superior vena cava and absence of the azygos vein: case report. Cardiovasc Intervent Radiol 13:47–49
Povoski SP, Khabiri H (2011) Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol 9:173. doi:10.1186/1477-7819-9-173
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Maiko Atari and co-authors have no conflicts of interest to declare.
Rights and permissions
About this article
Cite this article
Atari, M., Nakajima, Y., Fukuhara, M. et al. An extremely rare case report of surgery of lung cancer with the absence of azygos vein. Surg Radiol Anat 39, 103–106 (2017). https://doi.org/10.1007/s00276-016-1704-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-016-1704-z