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The existence of concomitant intra-abdominal pathology with abdominal aortic aneurysms is not uncommon. The optimal management is often controversial. We describe the successful treatment of a case of an abdominal aortic aneurysm (AAA) associated with a renal tumour without performing  a nephrectomy. An accessory lower pole renal artery supplying the tumour was ligated at the time of open AAA repair. The lower pole renal tumour (suspected renal cell carcinoma) reduced in size dramatically and progressively on follow-up computed tomography and the patient remains well at  over two years after surgery. The successful treatment of the two conditions in such a manner represents an alternative management strategy and adds to the options available in selected patients who present with challenging and unusual pathology.

Complete regression of renal tumour following ligation of an accessory renal artery during repair of an abdominal aortic aneurysm