Abstract
We report a case of tuberculous abdominal aortic aneurysm after intravesical instillations of bacillus Calmette-Guérin (BCG) therapy for bladder cancer. A 69-year-old man was referred to our hospital with a 5-month history of low back pain and 2-month history of relapsing fevers. One year previously he was treated for bladder cancer with transurethral resection, followed by adjuvant BCG therapy lasting 6 months. Computed tomography scanning demonstrated a pseudoaneurysm and perianeurysmal inflammatory changes in the region of the infrarenal aorta. An emergency operation was performed under a diagnosis of impending rupture of the tuberculous abdominal aortic aneurysm. The infrarenal aorta was successfully replaced with an in situ graft and the greater omentum was used to wrap the prosthetic graft. His postoperative course was uneventful and he was discharged on postoperative day 16 without any complications. Pathological findings revealed abdominal aortic wall with atheromatous disease and tuberculoid granuloma comprised of caseation necrosis, but acid-fast bacilli were not detected. We report a rare case of tuberculous aneurysm after BCG therapy with a review of the literature.
