Synchronous coexistence of liver metastases from cecal leiomyosarcoma and rectal adenocarcinoma: A case report.
Multiple liver tumors represent a challenging condition for abdominal surgeons both in the selection of technique and the rarity of diagnosis. There are no case reports on co-existence of liver metastases from both intestinal leiomyosarcoma and adenocarcinoma. The patient described in this report successfully underwent resection of both primary lesions and liver metastases in combination with chemotherapy. As for the leiomyosarcoma, the primary cecal lesion was revealed more than three years after the patient's first visit. Peritoneal, lymph-node, and lung recurrences were observed afterward, and thus surgeries on those regions were performed. Pathologically, the peritoneal and lung recurrences comprised leiomyosarcoma and the lymph-node recurrence was diagnosed as adenocarcinoma. Despite newly discovered multiple lung recurrences and regional lymph-node metastases, the patient lived a normal life for 73 mo after the initial operation based on multidisciplinary therapy. He ultimately died of liver failure due to invasive lymph-node recurrence from the rectal adenocarcinoma, in addition to multiple lung recurrences from the leiomyosarcoma. Hepatic recurrence did not occur in this patient's case, which appears to be one reason for his long-term survival.
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Hideki
H
Aoki
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Takashi
T
Arata
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Masashi
M
Utsumi
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Yutaka
Y
Mushiake
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Tomoyoshi
T
Kunitomo
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Isao
I
Yasuhara
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Fumitaka
F
Taniguchi
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Koh
K
Katsuda
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Kohji
K
Tanakaya
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Hitoshi
H
Takeuchi
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.
Rie
R
Yamasaki
D000230:Adenocarcinoma / Q000473:pathology*; D002430:Cecal Neoplasms / Q000473:pathology*; D002432:Cecum / Q000473:pathology; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology*; D008113:Liver Neoplasms / Q000556:secondary*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Adenocarcinoma; Chemotherapy; Leiomyosarcoma; Liver metastasis; Multiple liver tumors