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Case Reports
. 2023 Jan 5;12(2):443.
doi: 10.3390/jcm12020443.

Stage II Pancreatic Adenocarcinoma after Endovascular Repair of Abdominal Aortic Aneurysm: A Case Report and Literature Review

Zihuan Zhang  1   2 , Duo Li  1   2 , Tianxiao Wang  2   3 , Heyuan Niu  4 , Wenquan Niu  5 , Zhiying Yang  1   2
Affiliations
Case Reports

Stage II Pancreatic Adenocarcinoma after Endovascular Repair of Abdominal Aortic Aneurysm: A Case Report and Literature Review

Zihuan Zhang et al. J Clin Med. .

Abstract

Backgrounds: Concomitant abdominal aortic aneurysms (AAA) and gastrointestinal malignancies are uncommon. Endovascular repair (EVAR) is widely used to treat AAA. However, no consensus exists on the optimal strategy for treating AAA when associated with pancreatic adenocarcinoma. In addition, only few reports of pancreaticoduodenectomy (PD) after EVAR exist.

Presentation of case: A pancreatic tumor was detected during follow-up after EVAR for AAA in an 83-year-old female patient. The diagnosis was high-grade intraepithelial neoplasia. Modified pylorus-preserving pancreaticoduodenectomy was safely performed. The patient recovered moderately and was discharged two weeks after surgery. The pathological diagnosis was middle-grade pancreatic ductal adenocarcinoma. The patient survived for 24 months with no recurrence or cardiovascular complications.

Conclusions: Conducting periodic follow-ups after AAA surgery is helpful for the early discovery of gastrointestinal tumors. EVAR surgery is safe and feasible and thus recommended for AAA patients with pancreatic cancer, although it may increase the risk of cancer. The stage of malignancy and post-EVAR medical history can be valuable in evaluating the benefits of pancreatic surgery for such cases.

Keywords: abdominal aortic aneurysm; endovascular repair; pancreatic adenocarcinoma; pancreaticoduodenectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CT images of (a) intra-aortic endovascular stent in transverse arterial phase; (b) a solid tumor of 31 mm diameter in the pancreas head with dilatation of the central pancreatic duct in transverse venous phase; (c) sagittal plane showing an infrarenal AAA and the endovascular stent in coronal arterial phase; (d) location of pancreatic cancer and endovascular repair of AAA in sagittal venous phase.
Figure 2
Figure 2
Modified PPPD. PPPD: pylorus-preserving pancreaticoduodenectomy.
See this image and copyright information in PMC

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