Concomitant abdominal aortic aneurysm and malignant disease: a difficult management problem.

Medical records of 158 patients with abdominal aortic aneurysms seen between 1972 and 1984 were reviewed. Twenty patients, or 12.6%, had a histologically proven malignant neoplasm in addition to their aneurysm. The mean age of patients with cancer was 69 yr and for those without cancer, 68 yr. The most common cancers in this study were prostate, colorectal, and lung. Patients were placed in five categories according to the chronological presentation of the malignancy in relation to the aneurysm. Our study indicated that the incidence of malignant disease associated with abdominal aortic aneurysms is increasing. Absolute indications for operation initially on the aneurysm are the presence of symptoms or rupture. Absolute indications for operation initially on the malignancy are complications from the presence of the tumor such as hemorrhage, perforation, or obstruction. The type and stage of the cancer are major factors in determining operative treatment and priorities.