title: Successful resection of cecal hepatic metastasis extending into the right side of the heart under cardiopulmonary bypass.
abstract: Resection is the best hope for the cure of colorectal metastasis to the liver. However, surgery is indicated for only a few patients, especially those who have major vascular involvement. We report a 55-year-old woman with a liver metastasis from the cecum that showed a tumor thrombus in the right side of the heart. She had undergone laparoscopic right hemicolectomy for cecal cancer 6 months before, and presented with a palpable mass in the epigastrium. Abdominal ultrasonography, computed tomography, hepatic angiogram, and echocardiography showed a huge mass on the left lobe of the liver, with a tumor thrombus which extended to the right ventricle through the left hepatic vein and inferior vena cava. Tumor thrombectomy, through a right atriotomy, was success-fully performed under cardiopulmonary bypass, followed by left hepatic lobectomy. The patient's postoperative course was uneventful.
authors.affiliation: Department of Surgery, School of Medicine, Kyungpook National University, 50 Samduk-Dong. Taegu 700-721, Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Hwang
authors.forename: B H
authors.initials: BH
authors.lastname: Chang
authors.forename: J W
authors.initials: JW
authors.lastname: Kim
authors.forename: G S
authors.initials: GS
authors.lastname: Choi
authors.forename: Y K
authors.initials: YK
authors.lastname: Yun
authors.forename: A
authors.initials: A
authors.lastname: Chui
authors.forename: Y I
authors.initials: YI
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods; D002430:Cecal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D010690:Phlebography; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000473:pathology / Q000601:surgery*