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Left sided superior vena cava (with duplication)

Case contributed by Rupesh Namdev
Diagnosis almost certain

Presentation

A case of carcinoma of lower esophagus for CT chest to evaluate for lung metastases.

Patient Data

Age: 55 years old
Gender: Male

The anomalous vessel is seen continuing from the confluence of the left internal jugular vein and the left subclavian vein coursing inferiorly to the left of the arch of the aorta and anterior to the left hilum. The persistent left superior vena cava is seen draining into the left atrium. Also enlarged mediastinal lymph nodes are seen.

Case Discussion

Persistent left superior vena cava is the most common thoracic venous anomaly seen in approximately 0.3% of normal popultaion. During the embryonic life it is the counterpart of normal right sided superior vena cava which fails to obliterate.

In most of the cases, it drains into the coronary sinus while in less than 8% cases it is seen draining into the left atrium thus creating a small right to left shunt.

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