Background: Colon cancer with liver metastasis is a common occurrence in clinical practice. The presence of liver metastasis has a significant impact on the treatment strategy of patients, so the first step is to diagnose whether it is liver metastasis. Imaging is one of the auxiliary methods for diagnosing liver metastases, but due to the presence of different diseases with the same shadow, we need to be cautious when using imaging methods for the diagnosis of liver metastases.
Case presentation: We report a 53-year-old female patient with sigmoid colon cancer and perforation who underwent a surgical operation. Three years after the operation, reexamination of the liver through computed tomography and magnetic resonance imagery scanning revealed multiple progressive liver lesions. However, the liver biopsy did not show malignant changes. Repeated analysis of the patient's liver magnetic resonance imaging revealed that multiple liver nodules were significantly enhanced in the arterial phase and that the portal vein density/signal ratio was higher than that of the liver parenchyma. The coincidence of doughnut-shaped nodules and high signal in the hepatobiliary phase, combined with the results of pathological liver puncture examination, led to nodular regenerative hyperplasia being considered as a possible diagnosis.
Conclusion: A review of the relevant literature showed that following oxaliplatin chemotherapy for colorectal cancer, it is not uncommon for doughnut-shaped nodules with obvious enhancement in the middle hepatic artery phase and high signal intensity in the hepatobiliary phase to develop. Such changes should be paid sufficient attention by radiologists.
Keywords: Cancer metastasis; Colon cancer; Immunohistochemistry; Liver nodules; Nodular regenerative hyperplasia.
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