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Salvage lung metastasectomy by video-assisted transmanubrial approach.

Surgical treatment of lung metastasis has become common, but extended pulmonary metastasectomy is not accepted worldwide. We report a case of huge apical pulmonary metastasis of renal cancer with involvement of the subclavian vessels associated to two additional lesions of the lower lobe. All lung deposits were successfully removed through a combination of a transmanubrial cervicothoracic approach for the apical lesion and a videothoracoscopic technique for the nodules of the lower lobe.