Abstract
A 73-year-old man consulted our cardiology department for hypertension and post-myocardial infarction angina pectoris. After the examination, early gastric cancer was discovered at the lower gastric confines. Preoperative examination (abdominal CT scan) revealed an abdominal aortic aneurysm 7 cm in diameter and a left renal tumor. Simultaneous nephrectomy and repair of the abdominal aortic aneurysm were performed with a median retroperitoneal approach. Immediately after the operation, the white blood cell count increased transiently. At that time, the level of granulocyte colony stimulating factor (G-CSF) in the blood was high (81 pg/ml). The histopathological diagnosis of the tumor was renal cell carcinoma and immunohistochemical staining with an anti G-CSF antibody demonstrated cancer cells producing G-CSF. The postoperative course was uneventful. The patient underwent endoscopic resection of the gastric cancer 38 days after the first operation.
