title: T1 colorectal cancer with synchronous liver metastasis.
abstract: The patient was a 68-year-old man who was admitted to our hospital with a liver tumor. Abdominal ultrasonography and computed tomography revealed a liver tumor 30 mm in diameter. On colonoscopy, a pedunculated tumor with a central depression (20 mm in diameter) was observed in the ascending colon, and this tumor was considered to be invading deeply into the submucosal layer. Right hemicolectomy with D3 lymphadenectomy and partial hepatectomy were performed simultaneously. On histopathological examination of the resected specimen, the tumor was a well-differentiated tubular adenocarcinoma with 3,000 μm invasion of the submucosal layer. The liver tumor showed histological findings similar to those of the primary colorectal carcinoma. The pathological stage according to the 7th edition of the TNM classification was stage IV (T1N0M1). Nine months after the operation, computed tomography revealed hepatic hilar lymph node metastases and a great deal of ascites. The patient ultimately died 14 months after the operation.
authors.affiliation: Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Kiichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Masaya
authors.initials: M
authors.lastname: Kawai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takehara
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Tashiro
authors.forename: Shinya
authors.initials: S
authors.lastname: Munakata
authors.forename: Shun
authors.initials: S
authors.lastname: Ishiyama
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Komiyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kojima
authors.forename: Michitoshi
authors.initials: M
authors.lastname: Goto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tomiki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawasaki
keywords: Distant metastasis; Lymph node metastasis; Risk factor; Synchronous liver metastasis; T1 colorectal cancer
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