Synchronous resection of colorectal liver metastasis- a case report
We present a case report of a young patient of
Carcinoma sigmoid colon with multiple liver metastases who was
managed with synchronous resection of colorectal liver metastasis. The
patient had an ulceroproliferative growth in the sigmoid colon 18 cm
from the anal verge with multiple bilobar liver metastases. The CEA
level was 32 ng/ml. Preoperative evaluations of other organ systems
was normal. He was managed with Segment VI sparing extended right
hepatectomy, left hepatic metastatectomy and anterior resection with a
stapled colorectal anastomosis with a covering loop ileostomy.
Histopathological examination revealed moderately differentiated
adenocarcinoma colon (pT3N2M1). Multiple metastastic nodules were
present in all the specimens of resected liver with free margins of
resection. He has received adjuvant combination chemotherapy with
oxaliplatin + 5 FU + leucovorin in 21 day cycles (one cycle every 21
days) for a total period of 6 months. He has been in regular follow up
for last 48 months and is doing well without any local or systemic
relapse. With the low morbidity and mortality rates of modern day
surgery we recommend synchronous resection of colorectal liver
metastasis in a select group of patients in dedicated centres with
specialized expertise in hepatobiliary surgery.
Keywords: Colorectal, Carcinoma, Liver metastasis, Liver resection, Synchronous.
Internet Journal of Medical Update Vol. 3 (1) 2008: pp. 53-55