2020 Volume 48 Issue 3 Pages 129-137
A 70-year-old Japanese man was referred to our hospital. He had sigmoid colon carcinoma (cT3 N3 M0, cStage IIIb) with liver cirrhosis (Child classification, grade B), hepatocellular carcinoma (cT3 N0 M0, cStage III), and esophageal varices (Ls, F2, Cb, RC0, and Te). A self-expandable metallic stent (SEMS) had already been inserted. Considering the potential complications, radical surgery for the colon carcinoma was thought to be intolerable. The esophageal varices were treated with endoscopic injection sclerotherapy, and the hepatocellular carcinoma was treated with transcatheter arterial chemoembolization. During the clinical course, malignant obstruction due to ingrowth of the colon carcinoma was repeatedly experienced. Additional stent-in-stent SEMS insertion was successfully performed each time for a total of three times. The serum albumin level rose after each time SEMS was reinsertion. The patient died of progression of the hepatocellular carcinoma 369 days after the first SEMS insertion.
