A Case of Metastatic Liver Tumor Growing in the Bile Duct

Shuzo Kohno, Isao Kobayashi, Yutaka Oda, Takenori Hada, Hideichiro Ohmori^**, Kazuto Sasaya^**, Hiroshi Hano^* and Yoji Yamazaki^**

Department of Surgery, National Sanatorium Higashi Utsunomiya Hospital
Department of Pathology^* and Department of Surgery^**, The Jikei University School of Medicine

A 73-year-old male who had undergone anterior rectal resection for rectal cancer on December 5,1995 underwent hepatic subsequential resection on August 26, 1997. Although no findings of portal invasions were detected on an intra-operative ultrasonography, the cross section of the resected liver shows a multilobulated tumor consistent with adenocarcinoma, 17 mm in diameter and systemically infiltrating the bile duct, the surgical margin was positive. We performed a right hepatic lobectomy with partial resection of the diaphragm on July 8, 1998. Histopathologically, no residual malignant cells were detected at the cavity with necrosis formed by a previous resection, and tumor-cell growth along the bile duct in the portal area but negative surgical margin were revealed. It is very rare that growth in the bile duct from metastatic liver tumor can be detected macroscopically. We consider systemic liver resection to be effective for cases presenting with positive surgical margins by infiltration in the portal area.

Key words
liver metastasis, colorectal cancer, bile duct invasion

Reprint requests
Shuzo Kohno Department of Surgery, National Sanatorium Higashi Utsunomiya Hospital, 2160 Shimo-Okamoto, Kawachi-machi, Kawachi-gun, 329-1193 JAPAN

Accepted
September 22, 1999

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