[Curative Resection of Rectal Cancer with Simultaneous Pulmonary and Hepatic Metastasis by Multidisciplinary...

Treatment for distant metastasis in Stage Ⅳ rectal cancer is complicated. We report a case in which a patient with concurrent lung and liver metastasis achieved R0 resection through a multidisciplinary treatment combining staged surgical resection and systemic chemotherapy. The patient was a 60-year-old woman who presented with rectal bleeding and abdominal pain during defecation. Further examination revealed a type 2 tumor in the rectal RS region and suspicious metastatic tumors in the left lung S1+2 and liver S6/7, S7, leading to a diagnosis of rectal cancer Stage Ⅳb. Due to the symptom, laparoscopic low anterior resection was performed. As a diagnostic treatment, S1+2 subregional resection was performed on the lung lesions, confirming the diagnosis of lung metastasis. Ten courses of FOLFOX plus panitumumab were administered, resulting in shrinkage of the liver tumors in segments S6/7 and S7. However, a new lesion was suspected in segment S5 and partial liver resection was performed for the 3 lesions. All resected lesions showed pathological findings consistent with complete response(CR), and R0 resection was achieved.