Intratumoral Hemorrhage of Liver Metastasis from a Rectal Neuroendocrine Tumor

• Published in: Internal Medicine 2019/01/15, Vol.58(2), pp.217-223
• Main Authors: Hatanaka, Takeshi, Naganuma, Atsushi, Saito, Takahiro, Hoshino, Takashi, Kakizaki, Satoru, Kumasaka, Toshio, Takamoto, Takeshi, Makuuchi, Masatoshi
• Format: Article
• Language: English
• Subjects: Case Report; Colon; Colonoscopy; Computed tomography; Embolization; Embolization, Therapeutic - methods; Female; Hematoma; Hematoma - etiology; Hemorrhage; Hepatectomy; Humans; Internal medicine; intratumoral hemorrhage; Lesions; Liver; liver metastasis; Liver Neoplasms - complications; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Metastases; Microscopy; Middle Aged; neuroendocrine tumor; Neuroendocrine tumors; Neuroendocrine Tumors - complications; Neuroendocrine Tumors - diagnostic imaging; Neuroendocrine Tumors - secondary; Neuroendocrine Tumors - surgery; Pain; Rectal Neoplasms - diagnostic imaging; Rectal Neoplasms - surgery; Rectum; Tomography, X-Ray Computed; Ultrasonography
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.1140-18

A 56-year-old healthy woman was referred to our hospital for abdominal pain. Contrast-enhanced computed tomography (CT) showed a 14-cm-diameter liver tumor with intratumoral hemorrhage. We performed emergent transcatheter arterial embolization. She was referred to hepatic surgeon (M.M.) for resection. Preoperative colonoscopy showed an elevated lesion measuring 2 cm in diameter that was pathologically diagnosed as a rectal neuroendocrine tumor (NET). We performed low anterior resection of the rectum, followed by extended right hepatectomy for all hepatic lesions. Intratumoral hematoma was observed in the largest hepatic lesion (size: 150 mm×100 mm). Microscopy also indicated NET G2. We pathologically diagnosed a liver tumor from a rectal NET that bled spontaneously.