大腸癌肝尾状葉転移の切除例の検討

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  • A RESECTED CASE OF METASTASIS OF THE CAUDATE LOBE FROM COLORECTAL CANCER

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Primary cancer of the caudate lobe as well as rare metastatic caudate lobe cancer are expected to have poor prognosis because the anatomical specificity of the caudate lobe. We experienced a resected single metastasis in the caudate lobe from a colonic cancer. A 62-year-old male who had undergone total colectomy for multiple colorectal cancers 24 months before was found to have a 4cm mass lesion in the caudate lobe by ultrasonography. The mass was adjacent to the middle hepatic vein and left portal vein. The patient underwent an extended left lobectomy and caudate lobe resection under preparation of IVC shunt. Intensive hepatic arterial chemotherapy (5-FU+CDDP) was performed after the operation.<br> Five cases of resected single caudate lobe metastasis from colonic cancer have been reported. Four of them had a recurrence in the residual liver and none of them survived for 3 years after the resection of the caudate lobe. Caudate lobe metastasis, adjacent to the main vessels, may possiblely spread to other liver tissue secondarily. We think that the co-resection of the hepatic lobe adjoining to the caudate lobe tumor should be performed in terms of probable intrahapatic extension of the tumor, surgical tecnhique and hepatic functional reserve and intensive adjuvant therapy should be added for the residual liver.

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