title: The management of concomitant renal oncocytoma and giant coronary and bilateral common iliac artery aneurysms.
abstract: We present the rare case of a 66-year-old Caucasian male patient presenting with intermittent left-side abdominal pain. He underwent a kidneys, ureters, and bladder computed tomography scan on which an incidental 45-mm giant aneurysm of the left anterior descending coronary artery was discovered along with 55-mm right-sided and 62-mm left-sided common iliac artery aneurysms and a 100-mm benign renal oncocytoma. He underwent on-pump coronary artery bypass grafting of the left anterior descending, left circumflex and right coronary arteries using internal mammary artery and saphenous vein grafts. He subsequently underwent simultaneous open left nephrectomy and bilateral common iliac aneurysm repair using a bifurcated tube graft. He made a full recovery postoperatively. Giant coronary artery aneurysms are rare. In the pediatric population, they are predominantly secondary to Kawasaki disease. In adults, atheromatous disease is the leading cause. The coexistence of giant coronary artery aneurysms with extracoronary artery aneurysms is extremely unusual. We propose that the identification of giant coronary artery aneurysms necessitates further imaging investigations to identify the presence of extracoronary aneurysms. To our knowledge, this is the first description of such a case in the literature.
authors.affiliation: Outer North West London Regional Vascular Unit, North West London Hospitals National Health Service Trust, Northwick Park Hospital, Watford Road, Harrow, UK. Electronic address: jonnymclarke@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Clarke
authors.affiliation: Outer North West London Regional Vascular Unit, North West London Hospitals National Health Service Trust, Northwick Park Hospital, Watford Road, Harrow, UK; Department of Surgery, University of Queensland, Brisbane, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Choong
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Brompton and Harefield National Health Service Trust, Harefield Hospital, Hill End Road, Harefield, UK.
authors.forename: Shahzad
authors.initials: S
authors.lastname: Raja
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Brompton and Harefield National Health Service Trust, Harefield Hospital, Hill End Road, Harefield, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amrani
authors.affiliation: Department of Urological Surgery, North West London Hospitals National Health Service Trust, Northwick Park Hospital, Watford Road, Harrow, UK.
authors.forename: Giles
authors.initials: G
authors.lastname: Hellawell
authors.affiliation: Outer North West London Regional Vascular Unit, North West London Hospitals National Health Service Trust, Northwick Park Hospital, Watford Road, Harrow, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Hussain
mesh_terms: D018249:Adenoma, Oxyphilic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D003323:Coronary Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001026:Coronary Artery Bypass; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D009392:Nephrectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome