What happened, in summary

A 53-year-old woman underwent CT evaluation because of chest discomfort. Imaging showed a partially solid nodule in the left lower lobe, measuring about 2.8 x 2.6 cm and highly suspicious for early-stage lung cancer. Based on NSCLC treatment guidance, the team planned resection of the left lower lobe. She underwent single-port, single-direction thoracoscopic left lower lobectomy with lymph-node dissection under general anesthesia. During surgery, the lung fissure was incompletely developed, so the team proceeded in a sequence that involved the left lower-lobe vein, bronchus, and artery. While dissecting the left lower-lobe vein, they encountered unexpected technical difficulty and found an unknown vessel draining into the left lower-lobe vein. The surgeons paused to review the preoperative CT scans intraoperatively and identified an anomalous connection between the lingular vein of the left upper lobe and the left lower-lobe vein. Once this vascular variation was confirmed, the operation proceeded uneventfully without significant complications. She recovered well and was discharged on postoperative day 3. Final postoperative pathology showed Stage IB lung adenocarcinoma, classified as pT2aN0M0. Recognizing the anomalous pulmonary venous connection helped the team avoid unsafe vascular injury during minimally invasive lobectomy. Her early postoperative course was successful: the operation was completed without significant complications, and she left the hospital on postoperative day 3. The patient-facing outcome is completed surgical treatment with uneventful early recovery after Stage IB lung adenocarcinoma. The story also highlights careful surgical planning and intraoperative decision-making when uncommon pulmonary-vein anatomy changes the operative path for an individual patient.