Metastatic Liver Tumor Infiltrating the Inferior Vena Cava and the Biliary Tract with Difficult Differentiating from Cholangiocellular Carcinoma -A Case Report-

Masaaki Arai, Susumu Ohwada, Yasuo Morishita

The Second Department of Surgery, Gunma University School of Medicine

A 54-year-old woman with a previous history of low anterior resection for rectal carcinoma in October 1989 was admitted in May 1992 because of a hepatic tumor. The serum levels of CEA and CA19-9 were elevated. Computed tomograms and ultrasonograms identified an irregular tumor in the caudate lobe and right posterior superior segment infiltrating the inferior vena cava (IVC) and the posterior segment duct. Endoscopic retrograde cholangiograms showed a filling defect in the anterior segment duct and obstruction of the posterior segment duct. Hepatic angiograms revealed a fine tumor stain. These findings could not differentiate cholangiocellular carcinoma from metastasis attributed to rectal cancer. The right and caudate lobes of the liver were resected, together with partial resection of the IVC wall, the defect of which was repaired with a horse pericardium. The tumor, 4.0×3.5 cm in size, was histologically determined to be metastasis from rectal cancer with infiltration of the IVC and the biliary tract.

Key words
liver metastasis from rectal cancer, metastatic liver tumor infiltrating IVC and biliary tract, hepatectomy with IVC wall resection

Reprint requests
Masaaki Arai The Second Department of Surgery, Gunma University School of Medicine
3-39-15 shouwa-machi, Maebashi, 371 JAPAN

Accepted
November 1, 1993

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