Synchronous and Potentially Convertible Hepatic Metastases

Using this page you can select cases by clicking on the case number.

CASE 35: A 57-year-old woman presented with PET/CT evidence of a colonic mass with distention and 12 intrahepatic FDG avid lesions, mainly confined to the superior/posterior aspect of the right lobe but with some minor involvement of segments I and II. Colonic biopsy confirmed the presence of a poorly differentiated adenocarcinoma with focal signet ring features. (Presenter Dr. Axel Grothey, see other cases by Dr. Grothey)

CASE 36: A 39-year-old woman with a 1-year history of rectal bleeding, attributed to hemorrhoids, that preceded and continued throughout pregnancy initially presented postpartum with continued hematochezia. Workup showed a large fungating mass in the rectum and CT evidence of 4 small bilobar liver metastases (1 left lateral, 3 on right within segments V and VII). (Presenter Dr. Steven Alberts, see other cases by Dr. Alberts)

CASE 37: A 55-year-old active woman in seemingly excellent health presents at the emergency room with abrupt onset of abdominal pain and bloating. CT shows a near-obstructing mass in the distal colon, bilateral liver metastases (2 large lesions in segments VII and VIII superiorly and a 1.5 cm lesion in left lateral lobe) and questionable peritoneal metastases around her ovaries. (Presenter Dr. Steven Alberts, see other cases by Dr. Alberts)

CASE 38: An active 42-year-old man reporting a 2- to 3-year history of intermittent rectal bleeding presents with anorexia, fatigue and a 10-lb weight loss. Exam reveals enlargement of the liver with elevated LFT results, and colonoscopy shows a mass in the sigmoid consistent with colon cancer. CT demonstrates the presence of synchronous multiple (8+), large but potentially convertible metastases in both lobes of the liver, without evidence of extrahepatic disease. (Presenter Dr. Steven Alberts, see other cases by Dr. Alberts)

CASE 39: A 34-year-old female in excellent health presented with primary sigmoid cancer and synchronous extensive, right-hemiliver metastases in addition to PET/CT evidence of an involved perihilar lymph node. No additional extrahepatic disease was identified. (Presenter Dr. John Primrose, see other cases by Dr. Primrose)

CASE 40: A 76-year-old woman presented with an obstructing tumor in the splenic flexure and large synchronous metastases in the right peripheral hemiliver, with some extension to segment IV. A stent was placed to alleviate the emergent obstruction. (Presenter Dr. John Primrose, see other cases by Dr. Primrose)

CASE 41: An 80-year-old man presents with a primary nonobstructing cecal tumor and synchronous extensive right-side liver metastases (involving segments V-VIII). The left lobe is notably small and likely represents inadequate hepatic reserve if a complete right lobectomy were to be performed. (Presenter Dr. John Primrose, see other cases by Dr. Primrose)

CASE 42: A 48-year-old woman presents with elevated CEA levels and a 1-year history of rectal bleeding. Colonoscopy reveals a nonobstructing rectal adenocarcinoma 8 centimeters above the anal verge, and staging CT shows multiple synchronous hepatic metastases in the right hemiliver, appearing to encase the portal vein. No other sites of disease are identified. (Presenter Dr. Steven Curley, see other cases by Dr. Curley)

CASE 43: An obese 64-year-old woman with insulin-dependent diabetes presents with elevated LFT results and CT evidence of bilobar liver lesions suspicious for metastatic disease involving a significant portion of the right lobe with extension into segment IV. Colonoscopy reveals a nonobstructing adenocarcinoma in the descending colon. No extrahepatic disease was identified. (Presenter Dr. Steven Curley, see other cases by Dr. Curley)

CASE 44: A 48-year-old woman presented with asymptomatic primary colon cancer and approximately 20 highly distributed bilobar hepatic metastases. Disease was not found outside of the colon and liver. (Presenter Dr. René Adam, see other cases by Dr. Adam)

Copyright © 2008-2009 Research To Practice. All Rights Reserved.