A Case of Aortectomy for Resection of Recurrent Rectal Cancer on the Aortic Bifurcation after Chemo-radiation Therapy

Abstract

We present a case of recurrent rectal cancer on the aortic bifurcation which was treated with aortectomy and graft replacement after chemo-radiation therapy. The patient was a 55-year-old female. Her chief complaints were abdominal pain and bloody stool. She had undergone laparoscopic rectal resection with lymphadenectomy (D3) for rectal cancer. At 6 months after the first operation, PET-CT revealed recurrence of a tumor on the aortic bifurcation and the upper lobe of the left lung. She received chemo-radiation therapy, and then the recurrent para-aortic lymph node was removed by aortectomy and vascular graft replacement. The lung metastasis was resected one month there after. The recurrent tumors were completely removed (R0 resection) by two operations. Postoperative condition was good, but after a while, the cancer recurred on the mediastinal lymph node and bilateral multiple lung metastasis occurred. The patient died 1 year 9 months after the R0 resection.