title: The management of colon cancer in case of coexistence with an abdominal aortic aneurysm.
abstract: Colorectal cancer with the presence of an abdominal aortic aneurysm as a comorbidity factor is rare (0.5-2%) (1). Both diseases, while untreated, have a high degree of mortality (2,3). Management of such cases is a challenge for the surgeon, who confronts multiple dilemmas due to the particularity of this dual pathological entity. We present two clinical cases of adenocarcinoma of the colon concomitant with AAA, similar in many ways. Both cases were successfully treated regarding tumor excision by practicing right hemicolectomy. For each case a different strategy for vascular surgery was chosen. In the first case an EVAR (endovascular aortic repair) was performed. In the second case, because of the high risk of the aneurysmal sac operation, we opted for an expectation tactic. The presentation of these cases was chosen due to the rarity of their occurrence as well as because of the intention to highlight certain characteristic aspects. The main controversies debated are the necessity of treating the diseases simultaneously or in two stages, their approach order and the choice of an open surgery or an endovascular technique. From our experience and according to most literature, a staged therapy with EVAR in the first step is a method of choice. As surgical technique evolves, possibilities of endograft placement are expanding, thus, cases with more challenging anatomy can be approached.
authors.affiliation: Department I of Surgical Oncology, "Prof. Dr. Al. Trestioreanu" Institute of Oncology, Bucharest, Romania. andreas_eliescu@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Eliescu
authors.forename: E
authors.initials: E
authors.lastname: Brătucu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000150:complications / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D014408:Biomarkers, Tumor / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D018395:CA-19-9 Antigen / Q000097:blood; D003082:Colectomy; D003110:Colonic Neoplasms / Q000097:blood / Q000150:complications / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D011956:Receptors, Cell Surface / Q000097:blood; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D011956:Receptors, Cell Surface; C065686:carcinoembryonic antigen binding protein, human