A Case of Giant Liver Metastases from Rectal Carcinoid Accompanied DIC

Katuhiko Ito, Sinji Yanagisawa, Daisuke Okada, Nozomu Sakai and Masaru Miyazaki*

Department of Surgery, Nagano Prefectural Suzaka Hospital
Department of General Surgery, Chiba University Graduate School of Medicine*

In a 65-year-old man admitted to evaluate liver function a heterogeneously enhanced liver mass was found of 25×14 cm in diameter in the left lobe by enhanced abdominal CT. Moreover, colonfiberscopy revealed a submucosal tumor of 2.0 cm in diameter and an endscopic biopsy showed that the tumor was carcinoid. Before operation, we made a diagnosis of DIC (disseminated intravascular coagulation) because of a remarkable decrease in the number of platelets, an increase in FDP and a tendency to hemorrhage. Anti-coagulant therapy increased the platelet count and the operation was performed after 4 weeks of admission. The pathological diagnosis was carcinoid metastasis. After the operation, the level of platelets and FDP normalized. 4 months after the operation, the low anterior resection was performed for the rectal carcinoid. Sufficient consideration is necessary for any operation on a giant liver tumor accompanied by DIC.

Key words
rectal carcinoid, giant liver metastasis, DIC

Reprint requests
Katuhiko Ito Department of Surgery, Narita Red Cross Hospital
90-1 Iidacho, Narita, 286-8523 JAPAN

Accepted
January 25, 2006

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