2017 Volume 41 Issue 6 Pages 975-980
A 70-year-old-woman underwent laparoscopic sigmoidectomy for sigmoid colon cancer (moderately differentiated adenocarcinoma, pT3N0M0, pStage Ⅱ). A postoperative follow-up CT after 9 months revealed a low density area in the right branch of portal vein and the peripheral portal vein. The portal vein thrombosis was suspected and the anticoagulant therapy was received. The temporal CT findings showed that a low density area in the portal vein remained unchanged, but the subphrenic abscess and the right adrenal nodule were increased. Because both a low density area in the portal vein and the right adrenal nodule showed the 18FDG-PET uptake and the same echoic pattern, the right portal vein tumor thrombus and the right adrenal metastasis were suspected. Extended right lobectomy combined resection of right adrenal gland and right diaphragm with right portal vein resection and reconstruction was performed. Histopathological findings showed that both the tumor in the right portal vein and the right adrenal tumor are composed of similar adenocarcinoma with fibrous change and necrosis to the primary cancer.
As the portal vein tumor thrombus not associated with liver metastasis of colon cancer is extremely rare, this case is presented here together with some bibliographic comments.
