We present a rare case of.adenosquamous carcinoma of the lung (Ad-Sq) in a patient with complete situs inversus. The patient was a 76-year-old woman. Her chest X-ray film revealed a tumor (3.5cm in diameter) in the left lower lung field. She was referred and admitted to our department to undergo surgery. During surgery, particular care was exercised when intubating the Univent® bronchial tube for one lung ventilation. On thoracotomy, the left lung lobulated in three lobes, and pulmonary arteries and veins corresponded to the usual right-side pattern. Left lower lobectomy was successfully carried out. Postoperative diagnosis confirmed an Ad-Sq with localized pleural dissemination as p-t4nlm0, stage IIIb. Her postoperative course was uneventful. She received 2 courses of adjuvant chemotherapy using cis-platinum + vinorelbine at a nearby clinic. Twenty months after surgery, however, recurrent pleural dissemination was found in the left thoracic cavity. She died of disease 5 months thereafter. Preoperative angiographic examination of the three-dimensional CT (computed tomography) is useful for prevention of vessel injury during surgery in lung cancer patients with complete situs inversus undergoing lung resection. A review of the literature did not reveal any case of Ad-Sq complicating complete situs inversus.%患者は完全内臓逆位の76歳女性．血痕を認め近医を受診．胸部Ⅹ線とCTで左肺S~(10)に辺緑不整な空洞rn性病変を指摘され，精査・加療の目的で当科入院となった．cT2N1M0，ⅡB期肺癌を疑って手術を施行rnした．開胸すると左肺は3分乗で通常の右肺と同様の形態を呈していた．S~(10)に径4cm大の腫癌を認め，rn楔状切除し迅速病理診断に提軋 多形癌を疑われ，左肺下葉切除＋リンパ節（LN）郭清（ND2a）を施rn行した・病理所見は4.8×3.2×2.0cm大の腫瘍で異型の強い低分化扇平上皮痛が優勢で低分化腺病も混在，rnLN＃11に転移（＋），ly（＋），V（＋），dlのp-t4n1m0，StageⅢb低分化腺扁平上皮癌（Ad-Sq）と診断rnされた．転移LNもAd－Sqであった．補助化学療法を2コース施行したが，術後2年1カ月で胸膜播種rnにて死亡した．Ad-Sqは生物学的悪性度の高い癌であることが示唆された．完全内臓逆位に肺癌を合併rnした場合には．術前に分離肺換気や血管を中心とした解剖学的検討が必要である．
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