Curative Resection of Rectal Cancer Despite Liver Metastases

Abstract

In January 1989 the patient was investigated for heavy rectal bleeding. A fungating carcinoma of the rectum was diagnosed 10cm from the anal verge. The lumen at this level only just permitted examination by the colonoscope. Computerized tomography (CT) examination showed no evidence of perirectal spread, but both lobes of the liver appeared to contain numerous small metastases. The patient was informed that her life expectancy was approximately 12 months. A course of “palliative” radiotherapy (45Gy) was administered to the rectal tumour followed by a further treatment (6Gy) 1 month later. Sigmoidoscopy 3 months after treatment revealed no visible tumor, but subsequently recurrence occurred. Further radiotherapy (8Gy) and local excision with a urological resectoscope failed to control the lesion, and the patient was referred in July 1990.