Abstract
The simultaneous occurrence of Kommerell's diverticulum (KD), pulmonary sequestration (PS), and congenital pulmonary airway malformation type 1 (CPAM-1) represents an exceptionally rare clinical scenario. We present the first documented case of this triad in a young patient. We present a 14-year-old female with chronic cough and dysphagia underwent to thoracic CT and CT angiography revealing: 34 mm KD with aberrant left subclavian artery, Intralobar PS associated to CPAM-type1 features in the same pulmonary segment, mostly related to hybrid CPAM-sequestration lesion. This unique association suggests a shared embryological origin between vascular and pulmonary developmental anomalies. Imaging findings and multidisciplinary management are crucial given potential complications.