Concomitant Radical Cystectomy and Infrarenal Aortic Aneurysm Repair with Cryopreserved Aortic Allograft: A Case Report

In localized muscle invasive bladder cancer (MIBC), the gold standard treatment is radical cystectomy (RC) with bilateral pelvic lymph node dissection (PLND), associated with cisplatin-based neoadjuvant chemotherapy, whereas first-line treatment for metastatic patients is cisplatin-based chemotherap...

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Bibliographic Details
Published in:Uro 2022-01, Vol.2 (1), p.6-12
Main Authors: Cianflone, Francesco, Bianchi, Alberto, Novella, Giovanni, Tafuri, Alessandro, Cerruto, Maria Angela, Zivi, Andrea, Veraldi, Gian Franco, Antonelli, Alessandro
Format: Article
Language:English
Subjects:
Abdomen
Anticoagulants
Aortic aneurysms
Bladder cancer
Cancer therapies
Case reports
Chemotherapy
Cryopreservation
cryopreserved aortic allograft
Hypertension
infrarenal aortic aneurysm
Medical imaging
muscle invasive bladder cancer
Patients
Prostate
Synthetic products
Thrombosis
urothelial cancer
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Summary:In localized muscle invasive bladder cancer (MIBC), the gold standard treatment is radical cystectomy (RC) with bilateral pelvic lymph node dissection (PLND), associated with cisplatin-based neoadjuvant chemotherapy, whereas first-line treatment for metastatic patients is cisplatin-based chemotherapy. In men with an abdominal aortic aneurysm (AAA), elective repair is recommended when its diameter is >5.5 cm, while cryopreserved arterial allografts (CAA) offer resistance to infection. A patient with simultaneous metastatic MIBC, associated with left hydronephrosis, and infrarenal AAA of 49 mm diameter was evaluated in an interdisciplinary study. Concomitant surgery was opted for; first, the AAA repair with CAA implantation was practiced, followed by retroperitoneal and common iliac lymphadenectomy. Thereafter, RC and PLND were conducted, and a Wallace-1 ileal conduit and a stoma were constructed. Chest and abdomen contrast-enhanced CT at 2 months showed the onset of two osteolytic lesions on the left ilium. At oncological re-evaluation the patient was deemed cisplatin-fit.
ISSN:2673-4397
2673-4397
DOI:10.3390/uro2010002