Early Colorectal Cancer with Synchronous Liver Metastasis: Report of Two Cases

Yuji Takakura, Noriaki Tokumoto, Masazumi Okajima*, Satoshi Ikeda*, Takao Hinoi*, Masanori Yoshimitsu, Makoto Yoshida, Daisuke Sumitani and Toshimasa Asahara

Department of Surgery, Division of Frontier Medical Science and Department of Endoscopic Surgery and Surgical Science*, Graduate School of Biomedical Sciences, Hiroshima University

We report two cases of early SM colon cancer with synchronous liver metastasis. Case 1: A 70-year-old man with a protruding (Isp) 25 mm primary cancerous lesion of the transverse colon was found histologically to have well-differentiated adenocarcinoma, SM, ly0, v0. Computed tomography showed a huge 14-cm-diameter tumor in the right hepatic lobe, necessitating right hepatic lobectomy for intrahepatic cholangiocarcinoma. A definite histological diagnosis of colonic adenocarcinoma metastasis was obtained. Case 2: A 78-year-old woman was found to have a 20 mm IIa+IIc cancerous lesion in the cecum, together with a 2 cm liver tumor. Needle biopsy indicated colonic adenocarcinoma metastasis, necessitating ileocecal resection and partial hepatectomy. Histological findings for the primary lesion were well-differentiated adenocarcinoma, SM, ly0, v3, together with a definitive histological diagnosis of hepatic metastasis of colon cancer. Immunohistochemicaly hepatic specimens stained positive for CK20 and β-catenin and negative for CK7 in both cases. This was very helpful to make a diagnosis.

Key words
early colorectal cancer, liver metastasis, synchronous

Reprint requests
Yuji Takakura Department of Surgery, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University
1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 JAPAN

Accepted
November 19, 2008

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