A CASE OF MULTIPLE HEPATIC METASTASES FROM A COLONIC CANCER SUCCESSFULLY TREATED WITH MICROWAVE COAGULATION THERAPY

Abstract

We report a case of colonic cancer in which multiple hepatic metastases found intraoperatively were treated with microwave coagulation therapy and thereafter those metastases were histologically proved to be completely necrotized. A 58-year-old woman was admitted to the hospital because of colonic obstruction due to an advanced colonic cancer. Preoperative CT scan and ultrasonography revealed no hepatic metastases. When a left colectomy for the colonic cancer was performed, five metastatic lesions in the liver smaller than 1 cm in S4. S5, S6 and S7 segments were found out. A microwave needle electrode was inserted into the hepatic lesions to coagulate them in situ. Seven months after the operation a new metastatic lesion of the liver was detected, and nine months after the operation an extended right hepatectomy including all previously coagulated metastases was performed. Liver specimen histologically showed that coagulated hepatic metastases were completely necrotized. There has been no sign of recurrence, as of 18 months after the hepatectomy. We would stress that multiple hepatic metastses can be controlled with microwave coagulation therapy that offers a possibility of curative hepatic resection.