A 66-year-old man was admitted with repeated dysphagia. Gastroscopy confirmed the diagnosis of esophageal cancer. Potential metastasis was ruled out in an enhanced CT scan of chest and abdomen. However, 2 rare malformations were found: double aortic arch (DAA) and an accessory fissure of the azygos vein, as shown in Fig. 1. The DAA forms a vascular ring, which encircles trachea and esophagus. It is known to cause respiratory symptoms and dysphagia. A DAA is a rare type of congenital aortic arch anomaly, affecting approximately 0.005–0.007% of fetuses. Azygos lobe is a rare anatomic variant of right upper lobe seen in about 0.4% of population radiologically. Esophageal cancer in an adult, with DAA and a coexistent azygos lobe has not been reported. Awareness of this type of malformation is crucial in the surgical planning of esophagectomy.1,2
None.
