A Case of a 14cm Cystic Liver Metastasis from Sigmoid Colon Cancer that was Difficult to Diagnose Preoperatively

Abstract

A 47-year-old woman presented to the emergency department with sudden right-sided chest pain and a suspected ruptured giant cystic lesion in the right hepatic lobe. Closer examination revealed sigmoid colon cancer in addition to a giant cystic lesion in the liver. Cystic lesions in the liver are atypical for liver metastases of colorectal cancer, and hepatic cystadenocarcinoma or liver metastases of ovarian cancer were considered differential diagnoses. Laparoscopic sigmoidectomy was performed, followed by hepatic resection.

After sigmoidectomy, the cystic lesion increased in size and extended to the S4 and caudate lobes of the liver. Right hepatectomy with caudate lobe resection was performed and the postoperative course was uneventful. The histopathological diagnosis was liver metastasis of colorectal cancer. Rapid tumor growth led to extensive tumor necrosis, fluid retention, and cystic imaging findings.

Cystic liver metastases of colorectal cancer are extremely rare. We report a case of cystic liver metastasis from colorectal cancer that was difficult to diagnose preoperatively.