Abstract
An 81-year-old man was hospitalized with ileus despite regular hospital visits and a radiological procedure for a previous history of chronic hepatitis C with hepatocellular carcinoma treated by transcatheter arterial embolization (TAE). Computed tomography (CT) on admission showed an ileocecal tumor and multiple liver matastases and distant lymph node matastases despite the absence of any liver lesion in a magnetic resonance image (MRI) 2 months previous. We performed an ileocecal resection to release the ileus. Histopathological findings revealed that the tumor was composed of many different histological types such as ; mucinous carcinoma, signet ring cell carcinoma, hepatoid tumor, neuroendocrine tumor, rhabdoid feature, and mainly poorly differentiated adenocarcinoma. CT only 19 days after the operation showed a noticeable increase of liver and lymph node metastasis. He died at postoperative day 27 even though he received chemotherapy with mFOLFOX6.
