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1、Case reportCase ReportHarbin Medical University cancerHarbin Medical University cancer hospitalhospitalA case consultation:Liver metastasis after resection of rectal cancer HeiLongJiang tumor hospital.China Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalName:Xing XX
2、Gender:maleAge:63 years oldECOG:0Personal profileHarbin Medical University cancerHarbin Medical University cancer hospitalhospitalChief complaintResection of rectal cancer before 6 years,with liver metastasis for 1 month.Harbin Medical University cancerHarbin Medical University cancer hospitalhospit
3、alPresent history Extended radical resection for rectal cancer(Miles)was performed before 6 years in this hospital.The tumor was located under the peritoneal fold,with a size of 6*5*7cm,invading wall of intestine.Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresen
4、t history The pathologic diagnosis Rectal:moderately differentiated adenocarcinoma and mucinous adenocarcinoma with disc protrude type Invading wall of intestine A negative upper margin of resection Number of positive lymph nodes 0/22Harbin Medical University cancerHarbin Medical University cancer h
5、ospitalhospitalPresent history Clinical diagnosis based on the pathologic stage Rectal adenocarcinoma after resection pT4aN0M0 BHarbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Adjuvant Chemotherapy after surgery FOLFOX*8 Cycles Oxaliplatin 200mg d1 iv
6、gtt;Leucovorin 300mg d1-5 ivgtt;5-Fu 1g d1-5 ivgtt;Repeated every 2weeks Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Follow up2009.08-2014.05 CEA and CA199 monitoring and routine CT scanning were conducted every 3 month within 2 years and 6 months
7、 within 5 years after the surgery.Colonoscopy was performed every year.Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Recurrence2015-05-23 Upper Abdominal Enhancement CT:Liver Metastasis.Harbin Medical University cancerHarbin Medical University cance
8、r hospitalhospital肝转移病灶Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalA metastases with a maximum diameter of 14 cm diameter)was observed in the left lobe of the liver2015.05.23Plain CTPortal PhaseHepatic arterial phasePresent history RecurrenceTumor markers:CEA 113
9、.2ng/ml(0-5)CA199 135.3U/ml(0-37)NSE 23.77ng/ml(0-15.2)AFP 4.24ng/ml(0-7)Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Recurrence2015-06-01 Left liver lesion biopsy:Poorly differentiated carcinoma,consistent with metastatic carcinoma.Harbin Medical
10、University cancerHarbin Medical University cancer hospitalhospitalPresent history Recurrence 2015-06-01 Colonoscopy and Chest CT was Tumor Free.Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalChest CTChest CT2015.05.28 Pelvic CT2015.05.28 Pelvic CTPresent diagnosisRe
11、ctal cancer after resection pT4aN0M0 B Liver metastasisHarbin Medical University cancerHarbin Medical University cancer hospitalhospital RAS Gene Test2015-6-11 KRAS/NRAS WTHarbin Medical University cancerHarbin Medical University cancer hospitalhospital 临床诊断:直肠癌术后pT4N0M0 B期 肝转移 Present historyChemot
12、herapy after RecurrenceXELOX*1 Cycles Oxaliplatin 200mg d1 ivgtt;Capecitabine 1500mg am 2000mg pm d1-14 po;Repeated every 3 weeks Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent historyTumor marker after ChemotherapyHarbin Medical University cancerHarbin Medi
13、cal University cancer hospitalhospitalCEACA1992015.05.29Before chemotherapy 113.2135.32015.06.23 1 course later168.2157.7CEA:0-5ng/mlCA199:0-37U/ml Following treatmentResection?Chemotherapy?Portal vein embolization therapy?Chemotherapy combination with HAI(Hepatic Arterial infusion)?Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalHarbin Medical University cancerHarbin Medical University cancer hospitalhospital
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