Anomalous triad of a left-sided inferior vena cava, a retroesophageal right subclavian artery, and bilateral superficial brachial arteries in one individual

Abstract

We report a rare case of three major vascular variations in the same individual, two within the thorax and abdomen and one within the upper extremity. The observations were made in a cadaver of a 74-year-old Japanese woman. A single left-sided inferior vena cava was observed that began from the confluence of the left and right common iliac veins and ascended vertically to the left side of the abdominal aorta. After receiving the left renal vein, it passed obliquely upward anterior to the abdominal aorta, reaching the right side of the aorta, and then ascended vertically to the right atrium, following its normal course. The retroesophageal right subclavian artery was also present; it arose from the arch of the aorta as the last branch, passing obliquely between the esophagus and the vertebral column. Thus the right recurrent laryngeal nerve was not formed. Additionally, bilateral superficial brachial arteries were observed. They arose from the axillary artery, crossed over the medial root of the median nerve, coursed down the arm, and divided into the radial and ulnar arteries in the cubital fossa. Although each variation is not rare by itself, the triad of events is rare and important to clinicians, anatomists, and medical students.