[En bloc resection for apical invading lung cancer under anterior transcervical approach and assisted thoracoscopic procedure]

A 64-year-old male admitted for dry cough and fever was diagnosed with apical invading squamous cell carcinoma of left lung, and underwent operation. Anterior transcervical incision and removal of the sternoclavicular joint ensured vast and safe exposure of the thoracic inlet, and removal of the chest wall including the involved anterior 1st and 2nd ribs was underwent in safe by additional assisted thoracoscopic procedure in the supine position. After converting position, en bloc resection of the left upper lobe and chest wall, and lymph node dissection was performed under posterolateral thoracotomy. Anterior transcervical approach was useful to exposure of the thoracic inlet and the structures.