Superior sulcus tumor resection with multiple pulmonary arteriovenous fistulas.

The authors present a case of a 66-year-old male presenting with a superior sulcus tumor and severe hypoxemia due to bilateral multiple pulmonary arteriovenous fistulas. The unilateral pulmonary arterial occlusion test was useful before surgery because it enabled evaluation of the feasibility and safety of intraoperative pulmonary artery clamp and one-lung ventilation during lung resection. Results facilitated safe resection of the superior sulcus tumor using the modified transmanubrial osteomuscular sparing approach, providing an excellent surgical field.