Management of Concomitant Cancer and Abdominal Aortic Aneurysm

Abstract

Background. The coexistence of neoplasm and abdominal aortic aneurysm (AAA) presents a real management challenge. This paper reviews the literature on the prevalence, diagnosis, and management dilemmas of concurrent visceral malignancy and abdominal aortic aneurysm. Method. The MEDLINE and HIGHWIRE databases (1966-present) were searched. Papers detailing relevant data were assessed for quality and validity. All case series, review articles, and references of such articles were searched for additional relevant papers. Results. Current challenges in decision making, the effect of major body-cavity surgery on an untreated aneurysm, the effects of major vascular surgery on the treatment of malignancy, the use of EVAR (endovascular aortic aneurysm repair) as a fairly low-risk procedure and its role in the management of malignancy, and the effect of other challenging issues such as the use of adjuvant therapy, and patients informed decision-making were reviewed and discussed. Conclusion. In synchronous malignancy and abdominal aortic aneurysm, the most life-threatening lesion should be addressed first. Endovascular aneurysm repair where possible, followed by malignancy resection, is becoming the preferred initial treatment choice in most centres.

Abdominal Aortic Aneurysm and Malignancies

“…The patient's life expectancy in these cases is several months. If a resectable nongeneralized gastric carcinoma occurs concomitantly with AAA (about 2-3.8%) [30], early aggressive radical therapy is advisable ( Figure 6). In the event of a symptomatic AAA or AAA at risk of rupture, it is best to indicate EVAR treatment, which can soon be Abdominal Aortic Aneurysm and Malignancies http://dx.doi.org/10.5772/intechopen.76811 followed by resection of the tumor.…”

“…Certain exceptions are locally advanced rectal carcinoma, where preoperative neoadjuvant radiotherapy is indicated. In colorectal tumors concomitant with AAA (about 0.5-3.9%) [30], the symptomatic pathology should be treated first again, e.g., a tumor causing bowel obstruction (Figure 7) or bleeding vs. symptomatic painful aneurysm at high risk of rupture. In most cases, however, both lesions are asymptomatic and we have to decide about the treatment strategy.…”

The effect of recent chemotherapy in aorto-iliac aneurysm repair

“…[1][2][3][4][5] Open or endovascular aortic aneurysm repair (EVAR) either simultaneously with the malignancy or in a two-stage approach has been suggested as a feasible and safe treatment option.…”

Simultaneous surgical treatment of giant infrarenal aortic aneurysm and transverse colon cancer complicated by ileus

“…Потенциально открытое вмешательство на аорте и толстой кишке может сопрово-ждаться инфицированием протеза, а также формировани-ем аортоэнтеральной фистулы с последующим резким увеличением летальности [5,9,12]. Кроме того, повтор-ная лапаротомия при этапном открытом лечении также чревата рядом осложнений.…”