An educational tool to assist in the management of hepatic metastases in patients with colorectal cancer.

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      Film Review  

Discussant: FERGUS COAKLEY, MD (Dr Curley Case)


This is a contrast-enhanced CT image of the liver obtained in the portal venous phase at the level of the porta hepatis. A large, confluent, irregular metastatic lesion is located in the right lobe. It’s partially calcified and extends into segment IV, so there is bilobar involvement. Finally, a soft-tissue nodule can be seen in the porta hepatis that I would assess that more closely as a potential additional site of disease.


A dramatic response has occurred in the lesion — it is much smaller, almost bland and cystic looking in many areas, which probably indicates necrosis. The tumor has shrunk down and only now extends, it would appear, partially into segment IV, although it is still involved with the more anterior lesion being visible as it extends across the intersegmental fissure to involve the medial segment of the left lobe.













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