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Matteo Maria Cimino*, Fabio Procopio, Matteo Donadon, Luca Viganò, Daniele Del Fabbro, Guido Torzilli
Department of Surgery Division of Hepatobiliary & General Surgery, Humanitas Research Hospital & Humanitas University, Rozzano, MI, Italy

A 67 years old male in good general conditions performed abdominal ultrasonography and computed tomography (CT) for general discomfort showing colorectal liver metastases (CLM). Colonoscopy: non-occlusive lesion in 12 cm from the anal verge (ALL-RAS/B-RAF WT). PET FGD scan: liver only uptake. Partial response was obtained after 10 cycles of FOLFOX-Panitumumab. Multidisciplinary team indicates liver first approach due to disease extension (multiple CLM with bilateral main intrahepatic contact), chemotherapy response and asymptomatic primitive lesion. Parenchymal spare resection was performed (19 lesions removed) once a future remnant liver of 35% was calculated with a CT based 3D software.

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