A case of abdominal aortic aneurysm concomitant with advanced sigmoid colon cancer, chronic pyothorax, and thoraco-abdominal aortic aneurysm

Abstract

The management of patients with concomitant abdominal aortic aneurysm (AAA) and colorectal cancer is controversial. We report a case who underwent surgery for AAA and advanced sigmoid colon cancer (SCC). The 80-year-old man had a past history of chronic pyothorax. He developed conspitation and was diagnosed as having SCC. On pre-operative CT a thoraco-abdominal aortic aneurysm (TAAA), 57 mm in diameter, and an AAA, 65 mm in diameter, were noted ; no distant metastases of SCC were identified. We decided to observe the TAAA given the patient's age and the presence of chronic pyothorax. However, the AAA had a risk of rupture because of its cystic shape and size. Thus, the AAA and the SCC needed to be treated. We planed the operations so as to reduce the risk of graft infection and colostomy. First, the AAA was resected and grafted ; 1.5 months later, a sigmoidectomy was performed. The post-operative course was an eventful. Twenty-two months after the sigmoidectomy the patient is alive with no recurrence.