Concomitant colon cancer and abdominal aortic aneurysm treated by two-step endovascular aneurysm repair (EVAR) followed by laparoscopic sigmoidectomy

摘要

Concomitant gastrointestinal malignancy and abdominal aortic aneurysm (AAA) pose treatment difficulties. Herein we present the clinical features and treatment course of a 69-year-old male patient with AAA and sigmoid colon cancer. The maximum aneurysm diameter exceeded 50 mm, and it was evident from immediately after the bifurcation of the renal arteries. Due to the possibility of rupture, sigmoidectomy was preceded by endovascular aneurysm repair (EVAR). After confirming blood flow from the collateral arteries to the descending and sigmoid colon, a laparoscopic sigmoidectomy with lymph node dissection was safely performed one month after EVAR. The postoperative recovery was uneventful, and the patient was discharged 11 days after the second operation. Based on these findings and the literature, EVAR followed by the resection of colon cancer provides the safest order of treatments, especially when the patient has no cancer-related symptoms.