2024 Volume 57 Issue 11 Pages 551-558
The patient was a 57-year-old woman who was diagnosed with transverse colon cancer and synchronous metastatic liver cancer. CT showed multiple nodules with a ring-shaped contrast effect in both lobes. These hepatic lesions were initially thought to be unresectable. The patient underwent laparoscopic right hemicolectomy, and the postoperative diagnosis was pT3N3M1a(H3) Stage IVa. Chemotherapy of mFOLFOX6+panitumumab was administered, but chemotherapy-induced fatty liver change was observed and the liver/spleen ratio on CT decreased from 1.29 to 0.77. Oxaliplatin was stopped, but the other chemotherapy was continued. The liver/spleen ratio subsequently improved to 1.08, and the sizes of the metastatic lesions of the liver were markedly reduced. The patient then underwent curative liver resection and was discharged without postoperative complications. This case shows that, in management of chemotherapy-induced fatty liver, the liver/spleen ratio is easily monitored on CT images and is useful because it well reflects the degree of liver steatosis.
