Abstract
A 53-year-old woman brought to the hospital by ambulance due to lower abdominal pain, fever, headache, and vomiting had bilateral hypochondrial tenderness. Abdominal CT showed low-density lesions in both hepatic lobes, yielding a diagnosis of liver abscess. Ultrasonic guided puncture and drainage of the abscess was done and the patient was hospitalized. After hospitalization, bloody spots were noted in the stools and more thorough examination disclosed sigmoid colon cancer. Upper gastrointestinal endoscopy showed a 0-IIc lesion on the greater curvature of the upper stomach classified as group 4 based on a biopsy. During surgery, we found the lateral side of the liver was adhered firmly to the stomach and sigmoid colon cancer had infiltrated into the rectum, necessitating total gastrectomy, extended lateral hepatic segmentectomy, and low anterior resection. Pathological examination showed no evidence of metastatic lesions in the liver and findings did not contradict diagnosis of an abscess.
Given that the incidence of colorectal cancer complicated by liver abscess is relatively rare, we speculated that transportal infiltration by colorectal cancer resulted in formation of the liver abscess.
