Background : The liver is the most likely site of metastasis in colorectal cancer. Hepatitis B or C infection reduce the risk of metachronous colorectal cancer liver metastasis (CRLM), while incidence of extrahepatic metastasis is comparable in non-infected group. This suggests viral-related immune function may have a protective role against cancer cells colonization and proliferation in an injured liver through several mechanisms.

Methods : A case report of a colorectal cancer liver metastasis in a Hepatitis B patient in Hospital Teluk Intan, Perak, Malaysia.

Results : This case report highlights CRLM in a patient with Hepatitis B who successfully underwent radiofrequency ablation and completed chemotherapy with good outcome. A 58 years old Chinese lady with underlying Hepatitis B was diagnosed with rectal adenocarcinoma. CEA was 3.3. Initial CT TAP staging showed no distant metastasis. She underwent anterior resection, post operative complicated with anastomotic leak in which she underwent re-laparotomy and Hartmann’s procedure as second surgery. She was treated with antiviral for hepatitis B and proceeded with adjuvant chemotherapy. She was able to complete first-line chemotherapy. During surveillance 1 year post-surgery, CT TAP showed ill-defined segment VIII liver lesion may represent liver metastasis. PET scan revealed FDG-avid liver metastasis. Her liver function was normal, aFP was 11.4. She was started on second line chemotherapy. She was referred to hepatobiliary team and underwent radio frequency ablation. Repeated CT showed no residual or recurrence at ablated segment VIII lesion. Currently she has completed chemotherapy, 2 years post-surgery and is keeping well with good performance status.

Conclusions : Colorectal cancer liver metastasis although lower incidence can still occur in hepatitis patient. With the advancement of medical field, effective treatment modalities can produce favorable outcome for patient.