[A Case of Laparoscopic Liver and Colon Resection for Recurrent Hepatocellular Carcinoma and Metachronous Colon Metastasis of Hepatocellular Carcinoma].

An 81-year-old man underwent a partial laparoscopic hepatectomy for tumors in the S7 segment of the liver and was diagnosed with moderately to poorly differentiated hepatocellular carcinoma(HCC). Two years and 10 months later, MRI identified a 10 mm tumor in the S8 segment of the liver, indicative of highly differentiated HCC. Colorectal endoscopy subsequently revealed a submucosal tumor in the transverse colon, with biopsy findings showing features similar to the previous HCC. Immunohistochemistry results showed CDX2-negative, CK20-negative, and hepatocyte paraffin 1(Hep Par 1)-positive markers, confirming a diagnosis of metachronous colorectal metastasis of HCC. The patient underwent laparoscopic partial hepatectomy of the S8 segment and right hemicolectomy. Histopathological evaluation identified the liver tumor tissue as highly differentiated HCC, suggestive of metachronous multicentric recurrence. In contrast, the colonic tumor was characterized as moderately to poorly differentiated HCC, resembling the initial HCC. As there was no serosal exposure or lymph node metastasis, metachronous hematogenous recurrence of HCC in the colon was observed.