Yonenaga Y, Yokoyama S. Isolated liver metastasis detected 11 years after the curative resection of rectal cancer: A case report. World J Clin Cases 2021; 9(29): 8923-8931 [PMID: 34734076 DOI: 10.12998/wjcc.v9.i29.8923]
Corresponding Author of This Article
Yoshikuni Yonenaga, MD, PhD, Chief Doctor, Department of Surgery, Ako City Hospital, 1090 Nakahiro, Ako 678-0232, Hyogo, Japan. yyonenaga@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2021; 9(29): 8923-8931 Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8923
Isolated liver metastasis detected 11 years after the curative resection of rectal cancer: A case report
Yoshikuni Yonenaga, Satoshi Yokoyama
Yoshikuni Yonenaga, Department of Surgery, Ako City Hospital, Ako 678-0232, Hyogo, Japan
Yoshikuni Yonenaga, Satoshi Yokoyama, Department of Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Wakayama, Japan
Author contributions: Yonenaga Y was the patient’s surgeon, reviewed the literature, and contributed to manuscript drafting; Yokoyama Y was responsible for the acquisition of the patient’s clinical data and contributed to the revision of the manuscript for intellectual content; Both authors approved the final version of this manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yoshikuni Yonenaga, MD, PhD, Chief Doctor, Department of Surgery, Ako City Hospital, 1090 Nakahiro, Ako 678-0232, Hyogo, Japan. yyonenaga@gmail.com
Received: June 17, 2021 Peer-review started: June 17, 2021 First decision: July 5, 2021 Revised: July 6, 2021 Accepted: August 4, 2021 Article in press: August 4, 2021 Published online: October 16, 2021
Abstract
BACKGROUND
The duration of surveillance after curative resection of colorectal cancer (CRC) is generally 5 years. The overall incidence of recurrence more than 5 years after surgery for CRC in Japan has been reported to be 0.6%. Moreover, it is rare for CRC to have metachronous liver metastasis more than 10 years after surgery. Here, we present a case of liver metastasis detected 11 years after the curative resection of rectal cancer.
CASE SUMMARY
A 72-year-old man was referred to our hospital after a liver tumor was detected by abdominal ultrasonography at another hospital. He had undergone surgery for rectal cancer 11 years previously. Contrast-enhanced computed tomography (CT) showed a tumor with a diameter of approximately 8 cm in the posterior segment, which was weakly and gradually enhanced. 18F-fluorodeoxyglucose-positron emission tomography/CT showed an abnormally high uptake on the tumorous lesion, which showed that the tumor appeared to spread convexly along the intrahepatic bile ducts. Intrahepatic cholangiocarcinoma was therefore diagnosed, and he had an extended right posterior sectionectomy and regional lymph node dissection. Histopathological examination showed that the tumor was a moderately differentiated adenocarcinoma and showed the same pathological characteristics as the rectal cancer. Immunohistological examination showed that the cancer cells of both the liver tumor and rectal cancer were positive for cytokeratin (CK) 20 and weakly positive for CK 7. These findings were consistent with the liver metastasis from the rectal cancer.
CONCLUSION
It is possible that a liver tumor is metastatic in a patient with a previous history of CRC, even if it was more than 10 years earlier.
Core Tip: This case report presents a case with an isolated liver metastasis 11 years after surgery for rectal cancer. In addition, it is difficult to differentiate a late liver metastasis of colorectal cancer (CRC) from intrahepatic cholangiocarcinoma (ICC) preoperatively. We should note the possibility that a liver tumor in a patient with a history of curatively resected CRC might not be ICC nor hepatocellular carcinoma but metastasis from CRC, even if CRC was diagnosed and resected more than 10 years earlier.
