A Case of Surgical Resection of a Liver Metastasis from Colorectal Cancer with a Macroscopic Portal Vein Tumor Thrombus

Kazuki Sasaki, Yoshito Tomimaru, Hiroshi Wada, Hisataka Ogawa, Daisaku Yamada, Akira Tomokuni, Tadafumi Asaoka, Takehiro Noda, Kunihito Gotoh, Koichi Kawamoto, Shigeru Marubashi, Hidetoshi Eguchi, Hiroaki Nagano, Yuichiro Doki, Masaki Mori

Research output: Contribution to journalArticlepeer-review


The patient was a 65-year-old man. In July 2014, he was diagnosed with rectal cancer in a different hospital and underwent high anterior resection(type 2, T3N0M0, StageⅡ [TMN classification, 7th edition]). During the operation, a small nodule was detected in segment 4 of the liver. Contrast-enhanced abdominal CT revealed a tumor measuring 5 cm in diameter located in segment 4/8 of the liver with a tumor thrombus in the main trunk of the portal vein. In August 2014, the patient was referred to our hospital for further examination and treatment. MR imaging showed a lobulated tumor located in segment 4/8 of the liver. Gadoxeticac id-enhanced hepatobiliary phase MR imaging showed that the tumor was less enhanced than was the adjacent liver parenchyma. 18F-FDG-PET/CT demonstrated abnormal accumulation of 18F-FDG in the main tumor(SUVmax=18.3). There was no obvious abnormal accumulation in the other organs. In September 2014, he underwent extended left hepatectomy and portal vein tumor thrombectomy. The resected specimen showed a well-differentiated adenocarcinoma. Immunohistochemical staining results were CK7/CK20 (-/+) and CDX2 (+), which suggested that the tumor was derived from the gastrointestinal tract rather than the liver. The pathological diagnosis was a liver metastasis from rectal cancer. In the 6 months after the operation, intrahepatic recurrence was detected, and the patient was treated with systemicchemotherapy.

Original languageEnglish
Pages (from-to)1854-1856
Number of pages3
JournalGan to kagaku ryoho. Cancer & chemotherapy
Issue number12
Publication statusPublished - Nov 1 2015

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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