Abstract
We experienced a case of rectal cancer with ossification and liver metastasis resected simultaneously by laparoscopic surgery. The patient was a man in his fifties complaining of constipation and abdominal distension. Computed tomography and colonoscopy revealed intestinal obstruction caused by rectal cancer with multiple liver metastases (S2, 6, 8). We performed emergency colostomy, followed by laparoscopic low anterior resection (D3) and partial hepatectomy after an interval of one week. The pathological diagnosis of the resected rectal specimen was well differentiated adenocarcinoma with ossification ; the tumor directly invaded the urinary bladder. The resected liver metastases had no ossification. Despite adjuvant chemotherapy in our clinic, he developed recurrence in the liver remnant and he is on chemotherapy in our clnic as of 3 years and 2 months after the operation.
Previous reports indicate that the bone forming colorectal cancer accounts for about 0.4% of all colorectal cancers and that the tumors have center necrosis and are of low malignancy. However, our case in which bladder invasion and liver metastases were noted did was not of low malignancy. This is the first case of the rectal cancer with ossification and liver metastasis in which laparoscopic low anterior resection and hepatectomy were simultaneously performed.
