Hepatectomy following transarterial chemotherapy for a metastasis in the caudate lobe.
We describe a solitary liver metastasis in the caudate lobe from a colon cancer treated with a hepatic resection following transarterial chemotherapy. A 73-year-old male was admitted with a complaint of melena. The findings from endoscopic examination of the colon showed a type 3 cancer at the hepatic flexure. Computed tomography revealed a metastatic lesion in the caudate lobe of the liver, which was three centimeters in diameter and located between the roots of the middle and the left hepatic vein. A right hemicolectomy was performed and the surgical findings revealed extended lymph node metastasis and the serosal exposure of the primary lesion. A transarterial catheterization to the liver for chemotherapy was placed instead of performing a hepatic resection. After six months of the transarterial chemotherapy, the metastatic tumor was decreased to less than one centimeter and no other new lesion was developed in and out of the liver. The patient underwent a resection of the Spiegel lobe 8 months after the first operation. There were small lesions of viable metastatic cells in the tumor histologically. The patient is currently well without any signs of recurrence 28 months after the first operation.
Morise
Zenichi
Z
Department of Surgery, Saitama Municipal Hospital, Japan. zmorise@aol.com
Yamafuji
Kazuo
K
Asami
Atsunori
A
Takeshima
Kaoru
K
Hayashi
Noritaka
N
Baba
Hideo
H
Endo
Takashi
T
Hattori
Toshiaki
T
Ito
Yasuhiro
Y
Tokura
Yasuyuki
Y
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003110:Colonic Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D012086:Reoperation; D014057:Tomography, X-Ray Computed