[A case report treated in two-stage operations for lung cancer associated with arteriosclerosis obliterans (ASO)]

A case of lung cancer complicated with ASO treated surgically in two-stage procedures was reported. A 74-year-old male was admitted to our institution with the complaint of intermittent claudication. Chest X-rays showed shadows of a mass in the right upper lung field, and the tumor was suspected to be bronchogenic adenocarcinoma on the basis of findings of bronchoscopic brushing smears (class IIIb). Angiography revealed about 90% atherosclerotic eccentric stenosis in infra-renal abdominal aorta. Right upper lobectomy and lymph node dissection (R 2 a) was underwent through posterolateral thoracotomy. Pathological diagnosis showed the tumor was well-differentiated papillary adenocarcinoma and pathological TNM classification was T2N0M0. The secondary abdominal-bilateral common iliac bypass using artificial graft was performed through retroperitoneal approach 6 weeks after the first operation. Postoperative course was uneventful and the patient was discharged one month after the second operation. He is now leading normal life with both no relapse of cancer and no symptoms at 2 years and half after this two-stage operations.