A CASE OF METASTATIC LIVER TUMOR FROM A RECTAL CANCER WHICH INVADED THE CARDIA

Abstract

We experienced a case of metastatic liver tumor from a rectal cancer which invaded the cardia. A 58-year-old man who had an abdominal rectal resection for a rectal cancer in June 1991 become complained of dysphagia, vomiting and loss of body weight in February 1994. CT scan and ultrasonography showed a space occupying a lesion of 5cm in diameter in the liver S2 extending from the aorta to lesser omentum, and endscopy showed complete stenosis beneath the EC junction. In May, he was admitted to the hospital and was operated on. The tumor existed in the left lateral segment of the liver involving the diaphragma and cardia, and invaded the vena cava inferior and caudal lobe. Extended left lobectomy, caudal lobectomy, partial S5 resection, proximal gastrectomy, partial diaphragma and vena cava inferior resection, cholecystectomy were performed. A few reports of hepato-cellular carcinoma invading the adjacent organs have been seen, but so far we have never seen the case of metastatic liver tumor from a rectal cancer which invaded the cardia. We considered that, in this case, the metastatic liver tumor on the edge spreaded both inside and outside the liver. We think that such cases can be candidates for aggresive extended operation, if the tumor is able to be resected macrospically.