Minimal multiple liver metastases after chemotherapy from colorectal cancer could be revealed with intra operative ultrasonography using SONAZOID™

Abstract

A 57-year-old man diagnosed with advanced colorectal cancer showing 25 liver metastases not curatively resectable underwent internal sphincteric resection (ISR), then 8 chemotherapy (mFOLFOX6) courses. Thereafter, liver metastases shrank dramatically or disappeared, leaving 5 tumors detected in multi detector-row computed tomography (MDCT) and enhanced magnetic resonance imaging (MRI). In the second surgery, intraoperative ultrasonography using SonazoidTM showed 24 minimal hepatic tumors, necessitating right hepatectomy and left partial hepatic resection leaving no residual tumors. Seven months after hepatectomy, the man shows no sign of recurrence. In conclusion, intraoperative ultrasonography with SonazoidTM is a good modality for detecting minimal liver metastasis. © 2011 The Japanese Society of Gastroenterological Surgery.