TITLE:
Role of 3-Dimentional Computed Tomography Scan in Video Assisted Major Pulmonary Resection in Patient with Situs Inversus Totalis
AUTHORS:
Adnan Raza, Stephen Harden, Lukacs Veres, Khalid M. Amer
KEYWORDS:
3D-CT Scan, Virtual Reality Model, Total Situs Inversus, VATS Lobectomy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.8,
July
28,
2015
ABSTRACT: The aim of this case report is to raise
awareness about the use of 3-Dimentional Computed Tomography (3D-CT) virtual
reality imaging as a routine pre-operative tool for evaluation of unusual
anatomy such as Situs Inversus Totalis (SIT). We present a case of presumed
lung cancer in a 58 years old lady with SIT successfully treated by VATS
lobectomy via an anterior approach. She presented with an incidental solitary
pulmonary nodule in her right lower lobe, which had moderate FDG uptake on the
PET scan. The nodule was too deep to permit safe wedge biopsy, due to proximity
of a large pulmonary arterial branch. 3D-CT images were invaluable in
pre-operative assessment of the anatomy and were the key to safe completion of right VATS lower
lobectomy. Sectioning the lung after retrieval of the specimen suggested a
chondroid hamartoma; therefore, systemic nodal dissection (SND) was not
contemplated. The final histology confirmed the diagnosis of chondroid
hamartoma. In an unusual anatomy such as SIT, 3D-CT allows construction of virtual
reality models that can be viewed and manipulated before and during the
operation to understand the anatomy better, highlight caveats around target
structures and enable localisation of lesions unlikely to be palpated
intra-operatively.