Abdominal aortic aneurysm and concomitant malignancy: what treatment?

UNLABELLED

The association of neoplasm and abdominal aortic aneurysm (AAA), although rare, may represents a therapeutic dilemma.

MATERIALS AND METHODS

Between January 1990 and December 2004 in our departement 127 patients were submitted because of an AAA, in 8 cases there was an association with a neoplasm, in the greater part being a colon cancer. In 3 cases we performed a one stage surgery, in 1 case the chose was for a two stage surgery, for 3 patients we opted for an endovascular treatment by an endograft, in 1 case a pancreatic cancer was diagnosed 3 months after the prosthetic replacement of an AAA and there were no surgical indications because of the patient was in an advanced neoplastic stage.

RESULTS

There weren't any prosthetic infection or more serious complications. The endovascular treatments were performed successfully without complications after few days being followed by cancer's resection.

DISCUSSION

In case of this association the prognosis is related to neoplasm's stage. Timing depednds on the pathology that has the higher risk of short-term complication. Since Nineties author's reports in Literature about one stage surgery are more frequent, while now endovascular methods open new chances.

CONCLUSIONS

One stage surgery is a safe option in case of association between AAA and cancer. We think that a good porpouse is the use of a vascular endograft in aneurysmal treatment followed, after few days, by cancer's resection.