早期大腸癌に併発した肝炎症性偽腫ようの１切除例

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  • A CASE OF INFLAMMATORY PSEUDOTUMOR OF THE LIVER ACCOMPANIED BY EARLY COLON CANCER

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A 71-year-old man was admitted to the hospital because of general fatigue. On admission, he had no fever or abdominal pain. Loboratory data showed the white blood cell count and C-reactive protein within the normal ranges. Because he had been followed for chronic hepatitis C, abdominal computed tomographic scan was performed for screening and a low density mass was detected in the anterior segment of the liver. By abdominal angiography and magnetic resonance imaging scan, intrahepatic cholangiocellular carcinoma was diagnosed. We examined the upper gastrointestinal tract, colon and rectum to discriminate it from metastatic liver tumor and found a polypoid lesion of the sigmoid colon in the barium enema study. On biopsy of the sigmoid lesion by colonoscopy, adenocarcinoma was demonstrated. Accordingly we performed partial resection of the liver and sigmoidectomy based on the diagnosis of intrahepatic cholangiocellular carcinoma assosiated with early colon cancer though a possibility of metastatic liver tumor could not be ruled out. Pathology demonstrated that the liver tumor was inflammatory pseudotumor, while colon cancer was in the early stage. It is thought that careful diagnosis of inflammatory pseudotumor of the liver is particularly necessary when the patient also has malignant disease. We report this case along with a review of the literature.

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