Emergency caudate lobectomy for ruptured hepatocellular carcinoma with multiple primary cancers.
We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma (HCC) through hematogenous pathway. A 72-year-old woman was admitted to the emergency department with right upper abdominal pain for 4 h. Considering her surgical history of Mile's procedure plus liver resection for rectal cancer with liver metastasis three years ago and the finding of urgent computed tomography scan on admission, the preoperative diagnosis was spontaneous rupture of rectal liver metastasis located in caudate lobe and colonic metastasis from rectal cancer. The patient underwent an emergency isolated caudate lobectomy at a hemorrhagic shock status. Pathology reported a primary HCC in the caudate lobe and colonic metastasis of HCC with tumor embolus in the surrounding vessels of the intestine. No regional lymph node involvement was found. It is hypothesized that HCC may disseminate hematogenously to the ascending colon, thus making it a rare case.
Department of General Sugery, Tianjin Medical University General Hospital, Tianjin 300052, China.
Long-Hao
LH
Sun
Hong-Qiu
HQ
Han
Peng-Zhi
PZ
Wang
Wei-Jun
WJ
Tian
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D003110:Colonic Neoplasms / Q000556:secondary / Q000601:surgery; D003107:Colorectal Surgery; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012421:Rupture / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
Emergency isolated caudate lobectomy; Hematogenous metastasis; Hepatocellular carcinoma; Multiple primary malignancies; Rectal adenocarcinoma