Harbin Medical University cancer hospital
Present history
Recurrence
• 2015-06-01 Colonoscopy and Chest CT was Tumor Free.
Harbin Medical University cancer hospital
Resection of rectal cancer before 6 years ,with liver metastasis for 1 month.
Harbin Medical University cancer hospital
Present 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.
Present history
Tumor marker after Chemotherapy
CEA CA199
2015.05.29
Before chemotherapy
113.2
168.2
135.3
157.7
CEA：0-5ng/ml CA199:0-37U/ml
2015.06.23
1 course later
Chest CT
Chest CT
2015.05.28 Pelvic CT
2015.05.28 Pelvic CT
Present diagnosis
Rectal cancer after resection pT4aN0M0 ⅡB
Liver metastasis
Harbin Medical University cancer hospital
Harbin Medical University cancer hospital
Following treatment
Resection? Chemotherapy ？ Portal vein embolization therapy？ Chemotherapy combination with HAI (Hepatic Arterial infusion)？
Portal Phase
Hepatic arterial phase
Present history
Recurrence
• Tumor markers：
CEA 113.2ng/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 cancer hospital
Present history
Recurrence
• 2015-06-01 Left liver lesion biopsy: Poorly differentiated carcinoma, consistent with metastatic carcinoma.
Harbin Medical University cancer hospital
Personal profile
Name:Xing XX
Gender:male Age:63 years old
ECOG:0
Harbin Medical University cancer hospital
Chief complaint
Harbin Medical University cancer hospital
Present 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 0/22
RAS Gene Test
2015-6-11 KRAS/NRAS WT
Harbin Medical University cancer hospital
临床诊断： 直肠癌术后pT4N0M0 ⅡB期 肝转移
Present history
Chemotherapy after Recurrence
Байду номын сангаас
• 肝转移病灶
A metastases with a maximum diameter of 14 cm diameter) was observed in the left lobe of the liver
Harbin Medical University cancer hospital
2015.05.23Plain CT
Harbin Medical University cancer hospital
Present history
Follow up
• 2009.08-2014.05 CEA and CA199 monitoring and routine CT scanning were conducted every 3 month within 2 years and 6 months within 5 years after the surgery. Colonoscopy was performed every year.
Harbin Medical University cancer hospital
Present history
Recurrence
• 2015-05-23 Upper Abdominal Enhancement CT : Liver Metastasis .
Harbin Medical University cancer hospital
Harbin Medical University cancer hospital
Harbin Medical University cancer hospital
Harbin Medical University cancer hospital
Present history
Adjuvant Chemotherapy after surgery
• FOLFOX *8 Cycles Oxaliplatin 200mg d1 ivgtt; Leucovorin 300mg d1-5 ivgtt; 5-Fu 1g d1-5 ivgtt; Repeated every 2weeks
Case Case Report report
Harbin Medical University cancer hospital
A case consultation : Liver metastasis after resection of rectal cancer
HeiLongJiang tumor hospital.China
Harbin Medical University cancer hospital
Present history
Clinical diagnosis based on the pathologic
stage Rectal adenocarcinoma after resection pT4aN0M0 ⅡB
• XELOX *1 Cycles Oxaliplatin 200mg d1 ivgtt; Capecitabine 1500mg am 2000mg pm d1-14 po; Repeated every 3 weeks
Harbin Medical University cancer hospital