We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma(HCC) through hematogenous pathway.A 72-year-old woman was admitted t...We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma(HCC) through hematogenous pathway.A 72-year-old woman was admitted to the emergency department with right upper abdominal pain for 4 h.Considering her surgical history of Mile's procedure plus liver resection for rectal cancer with liver metastasis three years ago and the finding of urgent computed tomography scan on admission,the preoperative diagnosis was spontaneous rupture of rectal liver metastasis located in caudate lobe and colonic metastasis from rectal cancer. The patient underwent an emergency isolated caudate lobectomy at a hemorrhagic shock status.Pathology reported a primary HCC in the caudate lobe and colonic metastasis of HCC with tumor embolus in the surrounding vessels of the intestine.No regional lymph node involvement was found.It is hypothesized that HCC may disseminate hematogenously to the ascending colon,thus making it a rare case.展开更多
To the Editor:The patient was a 16-year-old adolescent boy who was diagnosed with congenital megacolon.He had difficulty with defecating for more than 10 years.His bowel movements stopped more than 1 week ago.He was a...To the Editor:The patient was a 16-year-old adolescent boy who was diagnosed with congenital megacolon.He had difficulty with defecating for more than 10 years.His bowel movements stopped more than 1 week ago.He was admitted to the hospital with incomplete intestinal obstruction.The patient showed signs of moderate nutrition,poor mental health,and full abdominal bulging and had an abdominal circumference of 104 cm. Rectal examination showed blasting exhaust and defecation, and the anal pressure measurement value was 89 mmHg.The total abdominal augmentation computed tomography and total colorectal sputum angiography showed that the upper and middle rectum,descending colon,transverse colon,and ascending colon were dilated,the maximum diameter of the intestine was 23 cm,and the intestine was filled with feces, suggesting that the lower rectum and sigmoid colon were narrow [Figure 1a and 1b].展开更多
文摘We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma(HCC) through hematogenous pathway.A 72-year-old woman was admitted to the emergency department with right upper abdominal pain for 4 h.Considering her surgical history of Mile's procedure plus liver resection for rectal cancer with liver metastasis three years ago and the finding of urgent computed tomography scan on admission,the preoperative diagnosis was spontaneous rupture of rectal liver metastasis located in caudate lobe and colonic metastasis from rectal cancer. The patient underwent an emergency isolated caudate lobectomy at a hemorrhagic shock status.Pathology reported a primary HCC in the caudate lobe and colonic metastasis of HCC with tumor embolus in the surrounding vessels of the intestine.No regional lymph node involvement was found.It is hypothesized that HCC may disseminate hematogenously to the ascending colon,thus making it a rare case.
文摘To the Editor:The patient was a 16-year-old adolescent boy who was diagnosed with congenital megacolon.He had difficulty with defecating for more than 10 years.His bowel movements stopped more than 1 week ago.He was admitted to the hospital with incomplete intestinal obstruction.The patient showed signs of moderate nutrition,poor mental health,and full abdominal bulging and had an abdominal circumference of 104 cm. Rectal examination showed blasting exhaust and defecation, and the anal pressure measurement value was 89 mmHg.The total abdominal augmentation computed tomography and total colorectal sputum angiography showed that the upper and middle rectum,descending colon,transverse colon,and ascending colon were dilated,the maximum diameter of the intestine was 23 cm,and the intestine was filled with feces, suggesting that the lower rectum and sigmoid colon were narrow [Figure 1a and 1b].
