Ascending Colon Cancer with Direct Invasion to the Liver Causing a Pyogenic Liver Abscess: Report of a Case

Hiroto Akiyama, Kaname Ono, Manabu Takano¹⁾ and Yuji Torimoto²⁾

¹⁾Department of Surgery, Inazawa City Hospital
²⁾Department of Surgery, Mitsubishi Nagoya Hospital

We report a case of ascending colon cancer with direct invasion to the liver causing a preoperative pyogenic liver abscess. A 69-year-old man presented with right flank pain and anemia. A barium enema study, ultrasonography, and computed tomography revealed an ascending colon mass with involvement of segment 6 of the liver. High fevers developed on the hospital day 7. Although imaging demonstrated a liver abscess in continuity with the tumor, intravenous antibiotics were administered without percutaneous transhepatic drainage for fear of cancer cell dissemination. Right hemicolectomy with partial resection of segment 5, 6 of the liver was performed. Postoperative recovery was uneventful. Inspection of the resected specimen revealed a fistula in the ulcerated cancer connecting to the liver parenchyma. Direct invasion to the liver by colon cancer has never been previously reported to cause a pyogenic liver abscess. Direct invasion to the liver and pyogenic hepatic abscess should be suspected in febrile patients with cancer of the ascending colon.

Key words
liver abscess, colon cancer invasion to the liver, cancerous fistula of colon cancer

Reprint requests
Hiroto Akiyama Department of Surgery, Inazawa City Hospital 1-1 Gokusho-cho, Inazawa, 492-8510 JAPAN

Accepted
October 31, 2000

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