Abdominal aortic aneurysm and concomitant malignancy: What treatment?

Abstract

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.