We present a case of cancer of the sigmoid colon, in which a left caudate lobectomy for a metastasis to the left caudate was performed 4 years after a right hepatic lobectomy with right caudate lobectomy for a metastasis to the right caudate lobe 6 years after an operation for the primary colonic cancer.
A 58-year-old woman underwent a sigmoidectomy for a carcinoma of the sigmoid colon in 1986. Two years after the operation, a right lobus inferior pulmonis metastasis was noticed and a right lobus inferior pulmonis resection was performed. During observation on an ambulant basis, in 1991, about five years after the first operation, the high level in CEA was confirmed, and CT and US examinations demonstrated a metastasis in the right caudate lobe. Right hepatic lobectomy+light caudate lobectomy was performed under a diagnosis of independent metastasis from the sigmoid colon carcinoma. After that, CEA decreased to normal range, but in 1994, about eight months after the first operation. CEA level increased again to 93.5 and CT and MRI revealed an independent metastasis in left caudate lobe, so a left caudate lebectomy was performed. There have been no signs of recurrence.