Preview

Research and Practical Medicine Journal

Advanced search

Multidisciplinary approach to the treatment of a patient with juxtarenal abdominal aortic aneurysm and renal cell cancer

https://doi.org/10.17709//2410-1893-2023-10-4-10

EDN: AJCFMC

Abstract

Currently, strategies for the management of tumor diseases of the urinary tract in combination with cardiovascular pathologies are controversial. In domestic literature, only isolated reports are found concerning the treatment of combined oncological and cardiovascular pathologies, and the global experience is limited to individual clinical observations and small retrospective series, primarily describing the experience of individual centers. The current challenge for specialists is to establish the ideal treatment sequence with regard to the optimal timing of each surgical procedure and the initial priority of treatment, or the possibility of performing them simultaneously. The article presents a case of successful simultaneous surgical intervention for juxtarenal abdominal aortic aneurysm (AAA) and renal cell carcinoma (RCC) of the left kidney. The patient underwent resection of an abdominal aortic aneurysm with the replacement of the left renal artery, resection of the left kidney under pharmaco-cold ischemia, with thrombectomy from the renal vein. The postoperative period proceeded satisfactorily. After 6 months, on the control computed tomography of the abdominal organs with contrast enhancement (CT) of the abdominal cavity with CU, the prosthesis of the abdominal aorta and the left renal artery are functioning. According to color duplex scanning (CDS) of the renal vessels, the blood flow in the left kidney is preserved to the periphery with normal speed indicators. No data on the recurrence of the oncological process were received.

About the Authors

A. V. Chupin
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation;

Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

 

Andrey V. Chupin – Dr. Sci. (Medicine), Head of the Vascular Surgery Department at the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation; Professor at the Department of Angiology, Cardiovascular, Endovascular Surgery, and Arrhythmology named after Academician A. V. Pokrovsky at the Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0002-5216-9970, SPIN: 7237-4582, AuthorID: 94735, Scopus Author ID: 6603104796, ResearcherID: ABD-5195-2021


Competing Interests:

Author state that there are no conflicts of interest to disclose.



N. R. Masalimov
Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

 

Nail R. Masalimov – PhD student of the Department of Angiology, Cardiovascular, Endovascular Surgery and Arrhythmology named after Academician A. V. Pokrovsky, Russian Medical Academy of Continuing Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0003-0052-8457, SPIN: 9440-5721, AuthorID: 1202771, ResearcherID: IXX-3203-2023

 


Competing Interests:

Author state that there are no conflicts of interest to disclose.



T. P. Baitman
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation;

Peoples' Friendship University of Russia, Moscow, Russian Federation

 

Tatiana P. Baitman – Researcher of the Department of Surgical Treatment of Urological Diseases at National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation; Assistant of the Department of Urology and Operative Nephrology with a Course of Oncourology, Medical Institute, Peoples' Friendship University of Russia, Ministry of Education and Science of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0002-3646-1664, SPIN: 4684-3230, AuthorID: 1064032, Scopus Author ID: 57219438104, ResearcherID: ABD-1099-2021


Competing Interests:

Author state that there are no conflicts of interest to disclose.



A. A. Gritskevich
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation;

Peoples' Friendship University of Russia, Moscow, Russian Federation

 

Alexander A. Gritskevich – Dr. Sci. (Medicine), Head of the Department of Surgical Treatment of Urological Diseases at the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation; Professor at the Department of Urology and Operative Nephrology with the Course of Oncourology at the Medical Institute, Peoples' Friendship University of Russia, Ministry of Education and Science of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0002-5160-925X, SPIN: 2128-7536, AuthorID: 816947, Scopus Author ID: 57194755867, ResearcherID: ABC-4256-2021


Competing Interests:

Author state that there are no conflicts of interest to disclose.



V. A. Kulbak
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation

Moscow, Russian Federation

 

Vladimir A. Kulbak – Cand. Sci. (Medicine), Senior Researcher at the Department of Vascular Surgery of the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0001-6743-4012, SPIN: 1111-0538, AuthorID: 780660, Scopus Author ID: 36650978100, ResearcherID: ABD-3334-2021


Competing Interests:

Author state that there are no conflicts of interest to disclose.



I. V. Miroshkina
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation

Moscow, Russian Federation

 

Irina V. Miroshkina – Junior Researcher at the Department of Urology of the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0002-5341-2100, SPIN: 8036-4759, AuthorID: 941028, Scopus Author ID: 57194755893, ResearcherID: ABD-1111-2021


Competing Interests:

Author state that there are no conflicts of interest to disclose.



E. V. Kondratyev
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation

Moscow, Russian Federation

 

Evgeny V. Kondratyev – Cand. Sci. (Medicine), Senior Researcher at the Department of Radiological Diagnostic Methods of the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0001-7070-3391, SPIN: 2702-6526, AuthorID: 243610, Scopus Author ID: 55865664400, ResearcherID: ABD-5758-2020


Competing Interests:

Author state that there are no conflicts of interest to disclose.



Ya. A. Stepanova
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation

Moscow, Russian Federation

 

Yulia A. Stepanova – Dr. Sci. (Medicine), Professor, Chief Scientific Secretary at the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0002-2348-4963, SPIN: 1288-6141, AuthorID: 561545, ResearcherID: D-6764-2018


Competing Interests:

Author state that there are no conflicts of interest to disclose.



I. E. Timina
National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation

Moscow, Russian Federation

 

Irina E. Timina – Dr. Sci. (Medicine), Senior Researcher at the Department of Ultrasound Diagnosis and Treatment of the National Medical Research Center of Surgery named after A. V. Vishnevsky, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

ORCID: https://orcid.org/0000-0001-7026-9417, AuthorID: 940606, Scopus Author ID: 24333032000


Competing Interests:

Author state that there are no conflicts of interest to disclose.



References

1. Kenyon J, Liu W, Dalgleish A. Report of Objective Clinical Responses of Cancer Patients to Pharmaceutical-grade Synthetic Cannabidiol. Anticancer Res. 2018 Oct;38(10):5831–5835. https://doi.org/10.21873/anticanres.12924

2. Onohara T, Kyuragi R, Inoue K, Yoshida S, Matsumoto T, Furuyama T. Late-Onset Malignant Neoplasms and Their Prognostic Factors after Abdominal Aortic Aneurysm Repair. Ann Vasc Surg. 2019 Apr;56:194–201. https://doi.org/10.1016/j.avsg.2018.08.095

3. Oliveiar-Pinto J, Mosquera N, Vidoedo J, Moreira-Sampaio S, Teixeira J. Co-existence of Abdominal Aortic Aneurysm with Urologic Neoplasm: Which Should Be Treated First in the Endovascular Era? Rev Port Cir Cardiotorac Vasc. 2017 Jul-Dec;24(3-4):187.

4. von Meijenfeldt GCI, Alberga AJ, Balm R, Vahl AC, Verhagen HJM, Blankensteijn JD, et al. Results from a nationwide prospective registry on open surgical or endovascular repair of juxtarenal abdominal aortic aneurysms. J Vasc Surg. 2022 Jan;75(1):81–89.e5. https://doi.org/10.1016/j.jvs.2021.06.031

5. Chaikof EL, Dalman RL, Eskandari MK, Jackson BM, Lee WA, Mansour MA, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018 Jan;67(1):2–77.e2. https://doi.org/10.1016/j.jvs.2017.10.044

6. Calero A, Illig KA. Overview of aortic aneurysm management in the endovascular era. Semin Vasc Surg. 2016 Mar;29(1-2):3–17. https://doi.org/10.1053/j.semvascsurg.2016.07.003

7. Keisler B, Carter C. Abdominal aortic aneurysm. Am Fam Physician. 2015 Apr 15;91(8):538–543

8. Clancy K, Wong J, Spicher A. Abdominal Aortic Aneurysm: A Case Report and Literature Review. Perm J. 2019;23:18.218. https://doi.org/10.7812/tpp/18.218

9. United Kingdom EVAR Trial Investigators; Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med. 2010 May 20;362(20):1863–1871. htt ://doi.org/10.1056/nejmoa0909305

10. Galt SW, McCarthy WJ, Pearce WH, Carter MF, Dalton DP, Garnett JE, et al. Simultaneous abdominal aortic aneurysm repair and nephrectomy for neoplasm. Am J Surg. 1995 Aug;170(2):227–230. https://doi.org/10.1016/s0002-9610(99)80292-x

11. Kira S, Sawada N, Kudou S, Zakoji H, Kaga S, Matsumoto M, Takeda M. Successful staged management of simultaneous abdominal aortic aneurysm and renal tumor: the novel minimally invasive treatment with endovascular aneurysm repair and retroperitoneal laparoscopic radical nephrectomy in an elderly and high-risk case. Clin Pract. 2012 Apr 12;2(2):e45. https://doi.org/10.4081/cp.2012.e45

12. DeMasi RJ, Gregory RT, Snyder SO, Gayle RG, Parent FN, Wheeler JR. Coexistent abdominal aortic aneurysm and renal carcinoma: management options. Am Surg. 1994 Dec;60(12):961–966.

13. Pattaras JG, Milner R. Staged minimally invasive treatment of inflammatory abdominal aortic aneurysm and renal cell carcinoma. Can J Urol. 2009 Apr;16(2):4596–4598.

14. Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer. Available at: https://gco.iarc.fr/today. Accessed 02.03.2020.

15. The state of oncological care to the population of Russia in 2020. Edited by A. D. Kaprin, V. V. Starinsky, A. O. Shakhzadova. Moscow: P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian Federation, 2021, 239 p. (In Russ.). Available at: https://oncology-association.ru/wp-content/uploads/2021/11/ zis-2020-elektronnaya-versiya.pdf. Accessed 01.11.2023.

16. Jongkind V, Yeung KK, Akkersdijk GJ, Heidsieck D, Reitsma JB, Tangelder GJ, Wisselink W. Juxtarenal aortic aneurysm repair. J Vasc Surg. 2010 Sep;52(3):760–767. https://doi.org/10.1016/j.jvs.2010.01.049

17. Peeters B, Moreels N, Vermassen F, van Herzeele I. Management of abdominal aortic aneurysm and concomitant malignant disease. J Cardiovasc Surg (Torino). 2019 Aug;60(4):468–475. https://doi.org/10.23736/s0021-9509.19.10946-9

18. Davydov MI, Akchurin RS, Gerasimov SS, Dzemeshkevich SL, Brand IaB, Dolgov IM, Shestopalova IM. Simultaneous surgery of competing cardio-vascular and malignant diseases of lungs and mediastinum. Pirogov Russian Journal of Surgery. 2010;(8):4–10. (In Russ.).

19. Imaev TE, Komlev AE, Akchurin RS. Cardiovascular surgery in cancer patients a new challenge for hybrid surgery. Cardiovascular Therapy and Prevention. 2019;18(4):99–104. (In Russ). https://doi.org/10.15829/1728-8800-2019-4-99-104

20. Jibawi A, Ahmed I, El-Sakka K, Yusuf SW. Management of concomitant cancer and abdominal aortic aneurysm. Cardiol Res Pract. 2011 Apr 19;2011:516146. https://doi.org/10.4061/2011/516146

21. Szilagyi DE, Elliott JP, Berguer R. Coincidental malignancy and abdominal aortic aneurysm. Problems of management. Arch Surg. 1967 Sep;95(3):402–412. https://doi.org/10.1001/archsurg.1967.01330150078012

22. Porcellini M, Nastro P, Bracale U, Brearley S, Giordano P. Endovascular versus open surgical repair of abdominal aortic aneurysm with concomitant malignancy. J Vasc Surg. 2007 Jul;46(1):16–23. https://doi.org/10.1016/j.jvs.2006.09.070

23. Baxter NN, Noel AA, Cherry K, Wolff BG. Management of patients with colorectal cancer and concomitant abdominal aortic aneurysm. Dis Colon Rectum. 2002 Feb;45(2):165–170. https://doi.org/10.1007/s10350-004-6138-8

24. Cvetkovic S, Koncar I, Galun D, Ribac J, Markovic M, Ilic N, Dragas M, Davidovic L. Treatment of a Patient with Abdominal Aortic Aneurysm and Hepatocellular Carcinoma. Ann Vasc Surg. 2017 Apr;40:295.e1–295.e4. https://doi.org/10.1016/j.avsg.2016.07.075

25. Třeška V, Hora M, Certík B, Moláček J, Houdek K, Náhlík J, Stránský P. Jednodobý výkon u aneuryzmatu břišní aorty a renálního karcinomu [Simultaneous procedure in patients with abdominal aortic aneurysm and renal carcinoma]. Rozhl Chir. 2014 Aug;93(8):424–427. Czech.

26. Hafez KS, El Fettouh HA, Novick AC, Ouriel K. Management of synchronous renal neoplasm and abdominal aortic aneurysm. J Vasc Surg. 2000 Dec;32(6):1102–1110. https://doi.org/10.1067/mva.2000.111539

27. Toursarkissian B, Mejia A, Wholey MH, Lawler MA, Thompson IM, Sykes MT. Endovascular AAA repair in a patient with a horseshoe kidney and an isthmus mass. J Endovasc Ther. 2001 Dec;8(6):604–608. https://doi.org/10.1177/152660280100800613

28. Mozafar M, Zarrintan S, Tubbs RS. Simultaneous resection of abdominal aortic aneurysm and left renal cell carcinoma: A rare case and review of the literature. J Cardiovasc Thorac Res. 2020;12(2):152–155. https://doi.org/10.34172/jcvtr.2020.26

29. Lawrie K, Whitley A, Balaz P. A systematic review and meta-analysis on the management of concomitant abdominal aortic aneurysms and renal tumours. Vascular. 2022 Aug;30(4):661–668. https://doi.org/10.1177/17085381211026827


Review

For citations:


Chupin A.V., Masalimov N.R., Baitman T.P., Gritskevich A.A., Kulbak V.A., Miroshkina I.V., Kondratyev E.V., Stepanova Ya.A., Timina I.E. Multidisciplinary approach to the treatment of a patient with juxtarenal abdominal aortic aneurysm and renal cell cancer. Research and Practical Medicine Journal. 2023;10(4):119-131. (In Russ.) https://doi.org/10.17709//2410-1893-2023-10-4-10. EDN: AJCFMC

Views: 342


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2410-1893 (Online)