Delayed onset of colorectal liver
metastasis (CRLM) > 5 years after primary colorectal surgery is rare. Herein, we report a case of delayed-onset CRLM that occurred 10 years after primary surgery, for which laparoscopic
hepatectomy was performed.
CASE PRESENTATION: A 68-year-old man was admitted to the hospital. His medical history revealed double
colon cancer detected 10 years ago, for which laparoscopic
colectomy was performed. The pathological
tumor-node-
metastasis stages were stages I and II. Thereafter, oral floor
cancer occurred 7 years after the primary surgery and was curatively resected. The annual follow-up with positron emission tomography-computed tomography (CT) identified a
tumor at segment 7/8 (S7/8) of the liver with an abnormal accumulation of fluorodeoxyglucose. Dynamic CT showed a 23-mm
tumor, with ring enhancement in the early phase. Magnetic resonance imaging with
gadolinium-ethoxybenzyl-
diethylenetriamine penta-
acetic acid demonstrated that the
tumor had high intensity in T2 weighted sequences and low intensity in the hepatobiliary phase. With a preoperative diagnosis of
intrahepatic cholangiocarcinoma or delayed liver
metastasis, laparoscopic S7/8 partial resection was performed. The
operative time was 324 min, and the intraoperative
bleeding volume was 35 mL. The patient was discharged on day 15 without any postoperative complications. Upon histopathological examination, the final diagnosis was CRLM. The patient has survived for 1 year without any recurrence.
CONCLUSIONS: It is important to pay attention to the occurrence of delayed-metachronous CRLM.