A CASE OF METASTATIC LIVER TUMORS OF THE RECTAL CARCINOID TREATED WITH HEPATIC ARTERY LIGATION AND CATHETERIZATION

A 69-year-old man was admitted to the hospital because of anal bleeding. There was an elevated lesion in the rectum which was histologically diagnosed as a carcinoid. Urinary 5-HIAA was normal. The patient was not with carcinoid syndrome. CT scan and ultrasonography revealed several liver tumors and the biggest one was 5×4 cm in size. Celiac arteriography didn't reveal hyper-vascular lesions. He underwent rectal amputation, hepatic artery ligation and catheterization into the hepatic artery. The rectal tumor was 3.0×3.5cm in size. Operative findings were RbRa type 1, A2P0H2N3(+). After the operation, intrahepatic infusion of 5-FU, MMC, and FAR were carried out. Forty-two days later, tumor in the right lobe which was 5 cm in diameter was reduced clearly. Metastatic liver tumors of the rectal carcinoid generally reveal hyper-vascularity in the angiography. Then, the interruption of the hepatic arterial blood supply is effective. But we experienced that hepatic artery ligation and intrahepatic chemotherapy were also effective for metastatic liver tumors that revealed normo-vascularity.