A CASE OF CARCINOID OF THE RECTUM IN WHICH INTRAHEPATIC CHEMOTHERAPY WAS EFFECTIVE FOR MULTIPLE LIVER METASTASES

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  • HISAMITSU Kazunori
    First Department of Surgery, Tottori University, Faculty of Medicine
  • MAKINO Masato
    First Department of Surgery, Tottori University, Faculty of Medicine
  • KIMURA Osamu
    First Department of Surgery, Tottori University, Faculty of Medicine
  • KAIBARA Nobuaki
    First Department of Surgery, Tottori University, Faculty of Medicine

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  • 多発肝転移巣に対して肝動注療法が有効であった直腸カルチノイドの1例

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Abstract

A 60-year-old male found out to have a 1.5×1.5cm elevated lesion with ulcer in its center in the posterior wall of the rectum about 4 cm from the anal verge at close examination for multiple liver tumors. With a preoperative diagnosis of rectal cancer with multiple liver metastases, low anterior resection and the cannulation into the hepatic artery via gastroduodenal artery was performed and a subcutaneus reservoir was retained for the purpose of regional chemotherapy. A definitive diagnosis was carcinoid of the rectum with multiple liver metastases that was confirmed by the presence of neuroendocrine granules in tumor cells using the electron microscope. Pararectal lymph node metastases were also observed. Intra-hepatic chemotherapy against metastatic tumors was effective and the patient has been followed on an ambulant basis while undergoing additional chemotherapy.<br> As the strategy against the rectal carcinoid with multiple liver metastases, the resection of the primary focus with regional lymphadenectomy and additional intrahepatic chemotherapy is recommended.

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