４回の肝切除により８年間生存中の同時性大腸癌肝転移の１例

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  • A Case of Hepatic Metastases From The Colon Surviving Eight Years After Four Hepatic Resections.

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We herein report a case of colon cancer metastatic to the liver which has underwent four hepatic resections and survived eight years. A 56-year-old man with abdominal distension was admitted to our hospital in May 1990 and underwent emergency laparotomy because of obstructive ileus. At laparotomy, transverse colon cancer and metastatic hepatic tumor were found. He underwent right colectomy and partial hepatectomy. Histological examination of the resected specimens showed moderately differenciated adenocarcinomas and the hepatic tumor was diagnosed as a metastasis from the colon. One year and seven months after the first operation, the patient was noted to have one nodule in the lateral segment on a routine follow-up CT scan. The patient underwent a second hepatic resection (lateral segmentectomy). Four years later, he had a CT scan that revealed two new nodules in segments 4 and 8. The patient underwent a third resection. Three years later, a follow-up CT scan reveals a new 4cm nodule in segment 5. The patient underwent fourth hepatic resection. Histologically, the resected specimen revealed evidence of moderately differenciated adenocarcinoma. The patient remains alive and well at 8 years after the first operation. There are few reports regarding the value of repeat hepatic resections in patients who have a recurrence in their liver following initial resection of hepatic metastases. This case illustrates that repeat hepatectomy for recurrent hepatic metastases is a viable option for the well selected patient.

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