We report a relatively rare case of adenocarcinoma of the colon with abdominal aortitis syndrome and nephrotic syndrome. A 72-year-old woman who had been medicated for nephrotic syndrome, hypertension, hyperlipidemia and iron deficiency anemia in our hospital since 1980 showed an exacerbation of anemia on blood examination in August, 1998.
Abdominal CT scan incidentally revealed stenosis of the abdominal aorta and atrophy of the left kidney. Abdominal aortitis syndrome was diagnosed. Preoperative intravenous digital subtraction angiography (IV-DSA) did not visualize the left renal artery and its periphery, but collateral artery to the femoral artery was revealed. Physical examination on admission showed hypotension of the legs. Blood examination showed iron deficiency anemia, and increase in carcinoembryonic antigen and carbohydrate antigen 19-9. Colonofiberscopy revealed colon cancer. With the diagnosis of colon cancer with abdominal aortitis syndrome, a right hemicolectomy with lymph nodes dissection (D2) and a biopsy of the right kidney were performed in October, 1998. The postoperative course was uneventful.