An Operated Case of the Heterochronous Liver
Metastasis of the Rectal Carcinoid

Toshiyuki Natsume, Shinichi Okazumi, Wataru Takayama, Akihiko Takeda, Koutaro Iwasaki, Shinichi Sasagawa, Akihiro Cho, Susumu Kobayashi, Takehide Asano and Takenori Ochiai

Second Department of Surgery, Chiba University School of Medicine

The patient was a 61-year old man. Polypectomies and transanal resection were perfomed for rectal carcinoid. After 9 years, US and CT revealed a SOL of 10cm in the S5 segment and a SOL of 5cm in the S7 segment of the right lobe of the liver. Right hepatectomy was performed under the diagnosis of liver metastasis of rectal carcinoid or cystadenocarcinoma of the liver. The resected specimens showed liver metastasis of rectal carcinoid. However US and CT performed 6 months after operation revealed a SOL of 2cm in the S2 segment of the liver and another SOL of 5cm in the S4 segment. The serum 5HIAA level was increased and the diagnosis of recurrent liver metastasis was made. Enucleations were performed. The tumor in the S2 segment was determined as liver metastasis of rectal carcinoid, but the S4 tumor was biloma. After undergoing two hepatectomies, the patient is alive and disease free 2 years and 3 months after operation.

Key words
rectal carcinoid, liver metastasis, hepatectomy

Reprint requests
Toshiyuki Natsume Second Department of Surgery, School of Medicine, Chiba University 1-8-1 Inohana, Chuou-ku, Chiba-city, 260-8670 JAPAN

Accepted
March 31, 1999

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