A Case of Hepatocellular Carcinoma with Metastasis to the Ascending Colon

Koji Matumoto, Yutaka Takano, Masaki Kanzaki, Mamoru Maeda, Hiroaki Mori, Shunsaku Miyoshi, Toshihiko Wakita¹⁾ and Shinichi Teshima²⁾

Department of Surgery, Department of Radiology¹⁾ and Department of Pathology²⁾, Fraternity Memorial Hospital

We report a rare case of metastatic hepatocellular carcinoma of the ascending colon. A 59-year-old man undergoing S5 partial hepatectomy for hepatocellular carcinoma at hepatic level S5 in May 2000 and hepatic S6 partial hepatectomy for thesame carcinoma in March 2001 was found in abdominal computed tomography (CT) in February 2007 to have tumor emboli in the right branch of portal vein's, and tumor staing at hepatic S5 and S6 in the arterial phase. When seen for melena in August 2007, he was found in abdominal computed tomography (CT) to have a neoplastic lesion containing aneurysm-like, dilated vessels in the lumen of the ascending colon. On colonoscopy, the lesion was found to be elevated, bled easily, and was embedded in proliferating vessels. Subsequent repeated episodes of melena left, the man in shock, embolization of the right colonic artery supplying the tumor under abdominal angiography. Although arterial bleeding was resolved, melena persisted, partial resection of the ascending colon containing the lesion. Histopathological examination yielded a diagnosis of tumor measuring 5.5 cm and hematogenous metastatic hepatocellular carcinoma of the ascending colon. Microscopically, tumor involved the mucosa, submucosa, muscularis propria, and superficial subserosa. After surgery, the man temporarily resumed alimentation but his liver function gradually deteriorated, liver failure ensued, and he died on postoperative day 18.

Key words
hepatocellular carcinoma, ascending colon, metastasis

Reprint requests
Koji Matsumoto Department of Surgery, Fraternity Memorial Hospital
2-1-11 Yokoami, Sumida-ku, 130-8587 JAPAN

Accepted
September 24, 2008

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