A Case Report of Metastatic Inferior Vena Cava Thrombus after Surgery for Panperitonitis due to Perforation of Rectal Cancer

Akira Kusuyama, Kimikazu Iwamoto, Naoya Watanabe, Satoshi Murata, Keizou Komuro, Hiroshi Ando, Kihachirou Itsubo

Department of Surgery, Daisan Hospital, The Jikei University School of Medicine

A 38-year-old woman underwent an operation for panperitonitis approximately 3.5 years ago, due to perforation of rectal cancer, characterized as Borrmann type 3 well differentiated adenocarcinoma. She was admitted to our hospital with abdominal mass and highly positive carcinoembryonic antigen (CEA) levels on October 1992, and diagnosed as having paraaortic lymph node metastases on the basis of abdominal ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) findings. At our second-look operation, however, inferior vena cava thrombus was found as a recurrence. It was histologically proved to be well differentiated adenocarcinoma. We believe this is the first report of metastatic inferior vena cava thrombus and lymph node metastases in pelvic cavity caused not direct invasion but hematogenous infiltrative growth without any other metastatic tumors after surgery for panperitonitis due to the perforation of rectal cancer.

Key words
inferior vena cava thrombus of rectal cancer, carcinoembryonic antigen

Reprint requests
Akira Kusuyama Department of Surgery, Daisan Hospital, The Jikei University School of Medicine
4-11-1 Izumihomachi, Komae, Tokyo, 211 JAPAN

Accepted
September 8, 1993

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