The patient was a 65-year-old male, who had been performed partial resections of the colon (descending
colon cancer and
rectal cancer: Stage IIIa). Multiple hepatic
metastases were observed 1 year and 10 months after the operation. Hepatic arterial infusion
chemotherapy was started, and a complete response for liver
metastases had been continuing for 2 years. On the seventh month after the hepatic arterial infusion
chemotherapy was started, a
lipoma-like
tumor of approximately 10 cm was found under the diaphragm on the left side. The
tumor was suspected to be a
lipoma on imaging and it had a tendency for enlargement. Two years and two months after hepatic arterial infusion
chemotherapy was begun, the patient was hospitalized for excision of the
tumor. Intraoperative findings indicated that there was a 3.5 cm mass in the greater omentum in addition to the aforementioned
tumor under the left diaphragm. Both masses were excised. The histopathological findings showed that the
tumor under the left diaphragm was composed of adipose tissue with coagulative
necrosis. The existing adipose tissue was thought to have necroses and had become encapsulated. Similar findings were obtained for the mass in the greater omentum. Contrast study using a port system revealed
stenosis of hepatic artery and defluxion of contrast medium into splenic artery and inferior phrenic artery. We speculated that the
lipoma-like
tumor was formed by the angitis with the change of the
drug distribution.