• Jun Yeb Nam, Jung Wook Lee, Jae Hyun Kim, Minjung Jung, Moo In Park, Won Moon, Sung Eun Kim, Kyoungwon Jung, and Seun Ja Park.
• Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
• Medicine (Baltimore). 2024 Apr 12; 103 (15): e37732e37732.

RationaleColorectal cancer is the third most common cancer diagnosed worldwide. At the time of diagnosis of colorectal cancer, one of the most common metastatic sites is liver. Gastric metastasis from colorectal origin is rare. Moreover, a direct invasion of the stomach, by hepatic metastasis from colorectal cancer, is particularly uncommon.Patient ConcernsA 56-year-old male patient with hematochezia was referred to our hospital.DiagnosisThe patient was diagnosed with unresectable colorectal cancer because of the presence of >10 metastases involving both lobes of the liver.Interventions And OutcomesAfter chemotherapy, the metastatic nodules in the liver nearly disappeared, except for a small nodule in segment VI. The patient underwent a radiofrequency ablation for the single lesion in the liver and laparoscopic low-anterior-resection for the primary tumor. Despite receiving various chemotherapy regimens, he experienced 6 recurrences, leading to 5 hepatectomies including a right hemi-hepatectomy, 1 pulmonary wedge resection, and 2 courses of radiation treatments. Lastly, a metastatic lesion in the liver was observed with invasion into the stomach. Subsequently, gastric wedge resection with resection of segments III and IV of the liver was performed. Direct invasion of the liver metastases into the stomach was confirmed histologically.LessonsThe patient is still alive, with a good quality of life, even after more than 8 years since the initial diagnosis. In the last instance of metastatic recurrence, direct invasion from the liver metastases into the stomach was observed, which is rare, and there are currently no reported cases.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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