title: [A Case of Surgical Resection of a Liver Metastasis from Colorectal Cancer with a Macroscopic Portal Vein Tumor Thrombus].
abstract: The patient was a 65-year-old man. In July 2014, he was diagnosed with rectal cancer in a different hospital and underwent high anterior resection(type 2, T3N0M0, StageⅡ [TMN classification, 7th edition]). During the operation, a small nodule was detected in segment 4 of the liver. Contrast-enhanced abdominal CT revealed a tumor measuring 5 cm in diameter located in segment 4/8 of the liver with a tumor thrombus in the main trunk of the portal vein. In August 2014, the patient was referred to our hospital for further examination and treatment. MR imaging showed a lobulated tumor located in segment 4/8 of the liver. Gadoxeticac id-enhanced hepatobiliary phase MR imaging showed that the tumor was less enhanced than was the adjacent liver parenchyma. 18F-FDG-PET/CT demonstrated abnormal accumulation of 18F-FDG in the main tumor(SUVmax=18.3). There was no obvious abnormal accumulation in the other organs. In September 2014, he underwent extended left hepatectomy and portal vein tumor thrombectomy. The resected specimen showed a well-differentiated adenocarcinoma. Immunohistochemical staining results were CK7/CK20 (-/+) and CDX2 (+), which suggested that the tumor was derived from the gastrointestinal tract rather than the liver. The pathological diagnosis was a liver metastasis from rectal cancer. In the 6 months after the operation, intrahepatic recurrence was detected, and the patient was treated with systemicchemotherapy.
authors.affiliation: Dept. of Gastroenterological Surgery, Graduate School of Medicine, Osaka University.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sasaki
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Hisataka
authors.initials: H
authors.lastname: Ogawa
authors.forename: Daisaku
authors.initials: D
authors.lastname: Yamada
authors.forename: Akira
authors.initials: A
authors.lastname: Tomokuni
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Asaoka
authors.forename: Takehiro
authors.initials: T
authors.lastname: Noda
authors.forename: Kunihito
authors.initials: K
authors.lastname: Gotoh
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000556:secondary / Q000601:surgery*; D008297:Male; D011169:Portal Vein / Q000473:pathology*; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*