Successful Concomitant Surgery for Abdominoperineal Resection and Right Hepatic Lobectomy with Thrombectomy

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Abdominal ultrasonography examination in a 70-year-old man revealed a hepatic mass in the right hepatic lobe. The examination revealed a hepatic tumor with tumor thrombosis in the right portal vein, and rectal carcinoma. To prevent cavernous transformation of the veins, intestinal bleeding, and ascites, we performed concomitant surgery for abdominoperineal resection and right hepatic lobectomy with tumor thrombectomy. The pathological findings of the resected specimens from the rectum and right hepatic lobe showed a moderately differentiated adenocarcinoma. Consequently, we diagnosed the patient as having rectal carcinoma and metastatic hepatic tumor with portal vein tumor thrombosis. We show that operating simultaneously on these conditions improved the prognosis for the patient. Moreover, the elevated tumor markers in the patient decreased dramatically 4 months after the surgery. The patient had no recurrence and was treated with continued adjuvant chemotherapy. This is the first successful case reported of concomitant surgery of abdominoperineal resection and right hepatic lobectomy with thrombectomy.