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Hepatectomy for liver metastasis from rectal cancer in a patient with mitochondrial disease
  1. Shogo Takei,
  2. Yuki Homma,
  3. Ryusei Matsuyama and
  4. Itaru Endo
  1. Department of Gastroenterological Surgery, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
  1. Correspondence to Dr Shogo Takei; shogo_takei37{at}


We herein report a woman who was suffering from type 1 diabetes and hearing impairment and whose mother had mitochondrial disease. Abdominal ultrasound identified a hepatic tumour, and a further examination led to the diagnosis of rectal cancer with synchronous multiple liver metastases. A genetic test led to the diagnosis of mitochondrial disease with a mitochondrial gene 3243A>G mutation. After neoadjuvant chemotherapy, we performed hepatectomy and low anterior resection in one stage. Hepatic vascular exclusion was not performed in order to prevent damage to hepatocytes due to liver ischaemia, and Ringer’s lactate solution was not used to prevent lactic acidosis. The postoperative course was uneventful. Only one other case involving hepatectomy being performed in a patient with mitochondrial disease has been reported. Considering the extreme rarity of such cases and the importance of perioperative management, we report this case here.

  • gastrointestinal surgery
  • colon cancer
  • metabolic disorders
  • diabetes

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  • Contributors Acquisition of data: ST, YH. Drafting the manuscript: ST. Revising the manuscript critically for important intellectual content: RM, IE. Approval of the version of the manuscript to be published: ST, YH, RM, IE.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.