We observed a case of long-term survival without recurrence following
hepatectomy and lung resection in a patient with hepatopulmonary
metastases, which appeared 7 months after
rectal cancer surgery. We report the case of a 68-year-old man whose chief complaint was anal
pain. The patient was referred to our hospital because of a suspected
rectal cancer. He was diagnosed with
rectal cancer without distant
metastasis, and
abdominoperineal excision was then performed. Histopathological findings revealed Rb, type 2, 85×60 mm, tub 2, ly1, v1, pPM0, pDM0, pRM0, pT3(A), pN0(0/27), cM0, and pStage Ⅱa. Seven months after the surgery, abdominal computed tomography(CT)revealed a 3 cm nodule in segment 7 of the liver. In addition, chest CT detected a 2 mm nodule in segment 3 of the upper lobe of the left lung.
Hepatectomy was immediately performed, whereas lung nodules were to be followed up. Three months later, chest CT showed that the lung nodules had increased in size(approximately 5 mm); therefore, the patient was diagnosed with lung
metastasis, and thoracoscopic partial lung resection was performed. The histopathological findings of the hepatic
tumor and lung
tumor were similar to those of
rectal cancer. The postoperative course was good, and the patient has been alive without recurrence for 8 years since the final surgery(lung resection)without postoperative
adjuvant chemotherapy.