Abstract
A 57-year-old man was admitted to our hospital because of anal bleeding and a rectal tumor which was pointed out at another hospital. On digital examination, a tumor of the rectum was palpated about 5cm from anal verge. The result of biopsy under rectoscopy showed carcinoid tumor. Ultrasonography and CT scan of the liver revealed multiple metastatic tumors of the liver, which had cystic pattern in the center of the tumor in S4. Celiac angiography demonstrated that hepatic arteries in the S4 and S8 had hypervascular pattern in the surrounding of the tumor. A local excision of the rectal carcinoid including muscle layer and an extended left hepatectomy were performed. Rectal and hepatic tumors showed similar findings immunohistologically. Therefore, we diagnosed his disease as rectal carcinoid tumor with multiple metastasis to the liver. For prevention of the recurrence, transarterial embolization was performed after the operation. There has been no sign of recurrence as of 19 months after the operation. It has been reported that carcinoid tumor of the rectum with liver metastasis has a poor prognosis, but aggressive hepatectomy appears effective.
