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A rare condition masquerading as lung cancer

© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. CASE REPORT A 63yearold woman was referred to the lung cancer clinic after presenting to the emergency department with a 10day history of fever, chest tightness and breathlessness. Chest Xray showed a leftsided retrocardiac mass, and an urgent CT scan was requested. On review, she reported a 2month history of intermittent cough and night sweats. She denied weight loss or haemoptysis. She was an exsmoker. Her medical history included two episodes of pneumonia in the 1980s. There was no history of recurrent childhood infections or exposure to tuberculosis. Performance status was zero and she worked for the NHS as an operating department practitioner. CT scan demonstrated a left lower lobe mass suspicious for malignancy. Preliminary radiological staging was T4N0M0 (figure 1). On positron emission tomography (PET)CT, the mass showed flurodeoxyglucose (FDG)avidity below the mediastinal blood pool. Subsequent review of the previous CT scan revealed direct arterial supply from the aorta with venous return to the azygous vein. These findings were reported as consistent with intralobar pulmonary sequestration (ILS) (figures 2 and 3). She was referred to the local cardiothoracic centre for further management and underwent surgical resection. Histology confirmed ILS. Surgery was uncomplicated, and she is recovering well postoperatively.