Situs İnversus Totalisli Hastada Sol Orta Lob Tümörünün Cerrahi Yönetimi

Situs inversus totalis is a rare congenital condition characterized by a complete mirror-image transposition of the thoracic and abdominal organs, which may introduce technical challenges during lung surgery due to reversed hilar anatomy.A 58-year-old woman was found to have a solid nodule located in the middle lobe positioned in the left hemithorax.Positron emission tomography demonstrated increased FDG uptake, and transthoracic needle biopsy confirmed adenocarcinoma.Preoperative mediastinoscopy revealed no N2 involvement.Because of extensive pleural adhesions unrelated to the tumor, video-assisted thoracoscopic surgery was deemed unsuitable, and an open middle lobectomy was performed.The postoperative course was uneventful, and final pathology confirmed i nvasive a denocarcinoma.T his c ase h ighlights t hat middle l obe t umors in patients with situs inversus totalis can be safely managed with appropriate preoperative staging and a carefully planned surgical approach, even in the presence of additional technical difficulties such as dense pleural adhesions.