2020 Volume 45 Issue 6 Pages 745-753
Abstract: A 71-year-old man underwent low anterior resection for sigmoid colon carcinoma that showed direct invasion of the ileum. The histopathological diagnosis was well-differentiated adenocarcinoma. One year two months after the surgery, a solitary liver nodule appeared in liver segment Ⅶ, which gradually increased in size. One year 10 months after the surgery, a solitary nodule appeared in segment Ⅳ of the right lung. The patient was initiated on combination chemotherapy with capecitabine + oxaliplatin + bevacizumab. After 5 courses of chemotherapy, since neither the lung tumor nor the liver tumors showed any response, synchronous thoracoscopic-assisted lung partial resection and transdiaphragmatic liver resection were performed. The histopathological diagnoses were non-keratinizing squamous cell carcinoma and well-differentiated hepatocellular carcinoma, respectively. Complete resection of metastases is, in general, associated with long-term survival in patients with Stage Ⅳ colorectal cancer. Since this approach is safe and useful, tumors that are close to the diaphragm represent a good indication for synchronous lung and liver resections.
