title: Hepar lobatum carcinomatosum associated with metastatic rectal carcinoma: an unusual cause of liver dysmorphy.
abstract: OBJECTIVE
  The aim of this study was to present a case of hepar lobatum resulting from metastatic rectal carcinoma.
  
  
  METHODS
  A 50-year-old man presented with a 2-year history of bleeding per anum, tenesmus, malaise and weakness. Initially, the patient received neoadjuvant chemoradiotherapy followed by abdominoperineal resection of the rectum. Abdominal computed tomography showed lobar enlargement and lobulated contour, mainly in the left lobe of the liver, but no primary or metastatic lesions were detected. Laparotomy revealed an irregularly lobulated hepatic deformity. Liver biopsy showed a necrotic tumor growth from adenocarcinoma of the rectum in subcapsular localizationof the liver.
  
  
  CONCLUSIONS
  This case showed a patient with hepar lobatum carcinomatosum caused by metastatic rectal carcinoma. The report further highlights the need for clinicians and surgeons to keep in mind the possibility of hepar lobatum carcinomatosum while caring for rectal carcinoma patients, especially when the lobulated contour of the liver is detected at preoperative imaging studies or when the coarsely lobated liver is encountered during surgery for carcinoma of the rectum.
authors.affiliation: Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey. zteke_md@yahoo.com
authors.forename: Zafer
authors.initials: Z
authors.lastname: Teke
authors.forename: Gurel
authors.initials: G
authors.lastname: Nessar
authors.forename: Saba
authors.initials: S
authors.lastname: Kiremitci
authors.forename: Erol
authors.initials: E
authors.lastname: Aksoy
authors.forename: Orhan Hayri
authors.initials: OH
authors.lastname: Elbir
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011859:Radiography; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil