Colorectal Liver Metastases Associated with Portal, Intrabiliary Tumor Thrombus and Peri-Choledochal Nodal Involvement: A Case Report

Takuya Saito, Tsuyoshi Sano, Yasuhiro Shimizu, Masataka Ando, Yoshiki Senda, Eiichi Sasaki*, Yasushi Yatabe* and Yuji Nimura

Department of Gastroenterological Surgery and Department of Pathology and Molecular Diagnostics*, Aichi Cancer Center Hospital

An 87-year-old woman was found in computed tomography (CT) to have multiple left lateral (S2, S3), right anterosuperior (S8), and right posteroinferior (S6) colorectal liver metastases. The left lateral tumor was associated with portal vein tumor thrombus. Her history of metachronous resection involved rectal cancer treated with endoscopic submucosal dissection when she was 72 years old and partial colectomy with lymph node dissection for advanced descending colon cancer when she was 84, followed by posterior pelvic excenteration for a recurrent tumor when she was 85 years old. At age 87, she further underwent left hemihepatectomy, left caudate lobectomy, partial resection at S6 and S8, and lymph node dissection around the hepatoduodenal ligament and common hepatic artery. The resected left lateral specimen was adenocarcinoma associated with either portal or intrabiliary tumor thrombus plus microscopic involvement of the pericholedochal lymph node. These observations were compatible with metastatic colorectal cancer. The postoperative course was uneventful, she was discharged on postoperative day 15, and has been doing well without signs or symptoms of tumor recurrence in the one year and one month since hepatectomy.

Key words
colorectal liver metastases, tumor thrombus, lymph node metastases

Reprint requests
Takuya Saito Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681 JAPAN

Accepted
September 24, 2008

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