Figure 9. Contraindication for transhiatal esophagectomy due to tracheal invasion in a 56-year-old man with SCC of the upper thoracic esophagus. CT scan (5-mm section thickness) obtained at the level of the left innominate vein shows an upper esophageal mass with suspicious invasion of the trachea (arrow) and an aberrant left subclavian artery (arrowhead) from the right-sided aortic arch. Ivor Lewis esophagectomy revealed tumoral invasion of the trachea and left subclavian artery.