Asian Journal of Case Reports in Surgery

Liver Metastasis of Gallbladder Cancer with Portal Venous Tumor Thrombosis

H. Hayashi *

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

H. Saito

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

D. Fujimori

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

K. Sugano

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

Y. Furutani

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

K. Sawada

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

K. Oyama

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

M. Kotake

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

T. Hara

Department of Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-Machi, Takaoka, Toyama, Japan.

*Author to whom correspondence should be addressed.

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Abstract

Aims: Gallbladder cancer (GBC) is associated with a poor prognosis in terms of biliary malignancies. Many patients with GBC patients develop liver metastasis and hepatoduodenal ligament involvement because of difficulties in early diagnosis. Herein, we report a case of GBC with liver metastasis, complicated with portal venous tumor thrombosis (PVTT).

Presentation of Case: An 87-year-old male patient was referred to our hospital with a persistent fever. Contrast-enhanced computed tomography (CE-CT) and Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) revealed multiple ring-enhancing space-occupying lesions at liver segments 4 and 5, and tumor thrombosis from segment 4, adjacent to the umbilical portion of portal vein, with gallbladder wall thickening. Subsequently, extended left lobectomy with cholecystectomy was performed, and postoperative histopathological examination revealed gallbladder cancer with multiple liver metastases and PVTT. The patient was discharged after 22 days of postoperative recovery without any symptoms. However, multiple recurrent liver tumors were confirmed on CE-CT after 42 days of hepatectomy.

Discussion and Conclusion: GBC liver metastasis with PVTT is rare but has aggressive clinical features and needs careful multidisciplinary treatment planning.

Keywords: Gallbladder cancer, hepatectomy, metastatic liver tumor, portal venous tumor thrombosis

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