Complex lobectomy in a patient with lung cancer and pulmonary artery sling

Pulmonary artery sling is a rare congenital anomaly of the origin and course of the left pulmonary artery. This condition typically presents with respiratory failure in young infancy, while asymptomatic cases are uncommon. We describe the case of an adult patient with a lung adenocarcinoma of the right upper lobe, extending into the hilum and superior mediastinum, and with a previously unknown pulmonary artery sling anomaly. The local invasiveness of the tumor and the peculiar vascular anatomy contributed to a unique surgical scenario, wherein multiple reconstructive procedures were required.