A case report of simultaneous operation for left lung cancer and abdominal aortic aneurysm

Abstract

We treated a 68-year-old man who had both left lung adenocarcinoma and abdominal aortic aneurysm. Main tumor of the left upper lobe formed a mass of 7cm in diameter with metastatic anterior-mediastinal lymph node, and the lung cancer was diagnosed as clinical stage IIIA (T3 N2M0). The infra-renal aortic aneurysm was 6cm in diameter. One stage operation was indicated for both lung and aortic lesions. Through median sternotomy and laparotomy with additional anterolateral thoractomy, left upper lobectomy with lymphadenectomy and aneurysmectomy with interposition of the abdominal aorta were performed simultaneously. The whole chest cavity was visualized well by using a lifting retractor substituted for rib retractor. Unclean manipulations such as transection of the bronchus and lung tissue were done after closing the abdomen. As microscopic invasion was detected in the adventitia of the aorta, the lung cancer was diagnosed as stage IIIB (pT4N3M0). The patient received additional mediastinal radiation therapy.