Percutaneous aortic stent placement for life threatening aortic rupture due to metastatic germ cell tumor.
Patients with testicular carcinoma frequently present with advanced disease and symptoms resulting from metastatic lesions. We report an unusual case of successful emergency management of a massive rupturing aortic pseudoaneurysm midway through systemic chemotherapy for stage III germ cell tumor by percutaneous trans-luminal placement of an aortic bypass stent-graft. Unstable hemorrhage was controlled, allowing our patient to complete chemotherapy and undergo elective retroperitoneal lymph node dissection with resection of the pseudoaneurysm and residual disease after normalization of tumor markers. Final pathological evaluation revealed only fibrosis in the resected tissue. Followup angiography demonstrated a patent stent-graft and the patient was without evidence of disease 1 year after retroperitoneal lymph node dissection.
Terry
P J
PJ
Division of Urology, University of Texas Health Science Center at San Antonio 78284-7845, USA.
Houser
E E
EE
Rivera
F J
FJ
Palmaz
J C
JC
Sarosdy
M F
MF
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000209:etiology* / Q000628:therapy*; D001019:Aortic Rupture / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D012186:Retroperitoneal Neoplasms / Q000556:secondary; D015607:Stents; D013724:Teratoma / Q000150:complications* / Q000188:drug therapy / Q000556:secondary*; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology*