Gastric cancer and a large abdominal aortic aneurysm treated in one operation

What happened, in summary

A 56-year-old man sought care for upper-abdominal pain, weakness, and increasing difficulty swallowing. Endoscopy found a large bleeding tumor in the upper stomach extending toward the esophagus, and biopsy showed gastric adenocarcinoma. Imaging also revealed a large infrarenal abdominal aortic aneurysm measuring about 6 cm. No distant metastases were identified.

Surgeons decided to address both serious problems in one operation. He underwent gastrectomy with resection of the involved lower esophagus and D2 lymph-node dissection, while the abdominal aortic aneurysm was repaired with a synthetic vascular graft. Pathology showed mixed gastric adenocarcinoma invading into the subserosal tissue, with cancer in 8 of 29 lymph nodes. Pathology classified the gastric cancer as Stage III.

His postoperative recovery was uncomplicated. He resumed oral intake after imaging on the fifth postoperative day and was discharged home on day 7 in satisfactory condition. He then received 8 courses of FOLFOX chemotherapy. During 1 year of follow-up, abdominal CT and upper gastrointestinal endoscopy found no local recurrence or distant metastasis. The case centers on successful coordinated treatment of gastric cancer and a major vascular condition requiring simultaneous surgery.