Abstract
We report a case of oral cancer that underwent surgery after graft replacement of the abdominal aorta for emergency abdominal aortic aneurysm and asymptomatic coronary artery bypass for 3-vessel coronary artery disease. A 66-year-old Japanese male had oral floor cancer, 3-vessel coronary artery disease and a huge abdominal aortic aneurysm, which were detected in preoperative examination. The patient underwent graft replacement of the abdominal aorta for the abdominal aortic aneurysm which was at high risk of emergent rupture. Two weeks later, the patient underwent coronary artery bypass graft to prevent perioperative myocardial infarction. A waiting period was necessary after the coronary artery bypass, so radiation therapy was administered to control tumor growth until surgery could be performed. Radiation therapy was completed with a dose of 30Gy and curative surgery was performed for oral cancer. The postoperative course was uneventful with no perioperative complications.
In this case, there were no abnormal findings, and the patient was asymptomatic despite having severe coronary artery disease. On the other hand, plain CT showed significant calcification of the coronary arteries. This case was associated with diabetes. Among diabetic patients, neuropathy may be asymptomatic in the presence of severe coronary artery disease. Therefore, it is considered important to detect coronary artery calcification by plain CT for preoperative screening in oral surgery including oral cancer.
