A Case Report of Metachronous Liver Metastasis from Rectal Carcinoma Presenting as an Extrahepatic Growing Tumor

Gaku Matsumoto¹⁾⁵⁾, Hideo Ise¹⁾, Haruyuki Inoue¹⁾, Noritaka Yabuki²⁾, Gen Tominaga²⁾, Takehiro Akahane²⁾, Wataru Kubota³⁾, Mika Watanabe⁴⁾, Noriyoshi Suzuki¹⁾ and Seiki Matsuno⁵⁾

Department of Surgery¹⁾, Department of Digestive Internal Medicine²⁾,
and Department of Radiology³⁾, Ishinomaki Municipal Hospital
Department of Pathology⁴⁾ and First Department of Surgery⁵⁾,
Tohoku University School of Medicine

We report case of metachronous liver metastasis from rectal carcinoma presenting as an extrahepatic growing tumor with macroscopic portal tumor thrombosis. A 74-year-old man, who had undergone amputatio recti for advanced rectal carcinoma 9 years ago, was admitted complaining of epigastralgia and fever. By ultrasonographic examination, an extrahepatic growing tumor about 6cm in size was revealed in segment 6 of the liver. CT scan and pharmacoangiographic portography examination demonstrated a portal tumor thrombosis at the right anterior branch of the portal vein. MR images disclosed that the tumor contained much hematoma and necrotic tissue at the center and viable carcinoma at the right marginal lesion. Right hepatic lobectomy was performed, and histologically, the tumor was diagnosed as moderately differentiated adenocarcinoma. Metachronous liver metastasis from rectal carcinoma sometimes occurs in an unusual form with portal invasion after a long postoperative period.

Key words
metachronous liver metastasis of the rectum, portal vein thrombosis, extrahepatic growing tumor

Reprint requests
Gaku Matsumoto Department of Surgery, Ishinomaki Municipal Hospital 1-7-20 Minamikawa-cho, Ishinomaki, 986-0835 JAPAN

Accepted
April 28, 1999

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