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Case Report Open Access

High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report

  • Authors:
    • Yuanhong Yang
    • Hao Zhang
    • Yifan Shen
    • Fan Yang
    • Dan Zhao
    • Yujie Lin
    • Guohua Huang
  • View Affiliations / Copyright

    Affiliations: Department of Proctology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China, High‑Intensity Focused Ultrasound Treatment Center, Suining Central Hospital, Suining, Sichuan 629000, P.R. China, Department of Oncology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
    Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 98
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    Published online on: January 7, 2026
       https://doi.org/10.3892/ol.2026.15451
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Abstract

Colorectal liver metastasis (CRLM) is typically associated with a poor prognosis. However, adopting multiple comprehensive treatment methods can significantly improve patients' long‑term survival rates. High‑intensity focused ultrasound (HIFU) is an emerging therapeutic technique that presents new treatment possibilities for patients. The present study reports the case of a patient who was diagnosed with liver metastasis following laparoscopic rectal cancer surgery. After unsuccessful tumor control with classical chemotherapy, radiofrequency ablation and interventional embolization therapy, the patient underwent HIFU treatment, which resulted in complete tumor remission and >10 years of tumor‑free survival. In this case, HIFU treatment significantly improved tumor control without causing additional trauma. This case highlights a successful multimodal treatment approach for CRLM and provides valuable insights for similar cases, underscoring the importance of personalized treatment that integrates multiple therapeutic modalities. As a non‑invasive and innovative technique, HIFU demonstrates significant potential in providing a new avenue for the future treatment of CRLM.
View Figures

Figure 1

Preoperative computed tomography scan
and postoperative pathological. (A) Thickening of the intestinal
wall at the junction of the sigmoid colon and rectum (arrow). (B)
Enlarged perirectal lymph nodes (arrow). (C) Postoperative
pathology reveals moderately to well-differentiated ulcerative
adenocarcinoma (H&E staining; ×400 magnification). H&E,
hematoxylin and eosin.

Figure 2

Enhanced computed tomography scans 3
months after surgery. (A) A 14×11-mm lesion beneath the liver
capsule in the right lobe (arrow). (B) An 8×7-mm lesion adjacent to
the right portal vein (arrow). (C) A 17×14-mm lesion at the apex of
the right lobe (arrow). (D) A 15×15-mm lesion in the left lobe
(arrow).

Figure 3

Pathological and computed tomography
imaging in the left lobe of the liver following radiofrequency
ablation. (A) Histopathology of the lesion in the left lobe of the
liver reveals that the cells are arranged in irregular glandular
structures with infiltrative growth. The nuclei are enlarged and
nucleoli are prominent. The pathological diagnosis is metastatic
colorectal carcinoma to the liver. (B and C) A clustered
heterogeneous density shadow can be seen in the left lobe of the
liver, with gas density shadows within it (arrow). The adjacent
greater omentum is thickened. The results suggest infection.

Figure 4

Enhanced computed tomography scans
following transarterial chemoembolization. (A) The lesion beneath
the liver capsule in the right lobe shows no significant reduction
in size compared with before, with mild enhancement (arrow). (B)
The lesion adjacent to the portal vein in the right lobe still
shows mild enhancement (arrow). (C) The lesion at the apex of the
right lobe of the liver shows no significant reduction in size
compared with before, with mild enhancement (arrow).

Figure 5

Enhanced computed tomography scans 3
weeks after high-intensity focused ultrasound combined with
chemotherapy. (A) The lesion beneath the liver capsule in the right
lobe disappeared (arrow). (B) The lesion adjacent to the portal
vein in the right lobe disappeared (arrow). (C) No evident
enhancement can be observed in the lesion at the apex of the right
lobe (arrow).

Figure 6

Enhanced computed tomography scan
after chemotherapy on day 2. No evidence of the lesion at the apex
of the right lobe of the liver can be observed.

Figure 7

Left liver lesion: Pre- vs. post-HIFU
comparison. (A) Pre-HIFU enhanced computed tomography scan
demonstrating a clustered low-density mass with streaky low-density
components in the left lobe of the liver, showing mild enhancement
and attenuation in the venous phase (arrow). (B) At 3 months
post-HIFU, a low-density mass can be observed in the left lobe of
the liver, without evident enhancement (arrow). HIFU,
high-intensity focused ultrasound.

Figure 8

Timeline of changes in CEA levels
(normal range, 0–5 ng/ml). The CEA level was 2.66 ng/ml before
radiofrequency ablation and chemotherapy, peaked at 7.45 ng/ml
during treatment, decreased to 1.8 ng/ml after combined therapy,
and then remained within the normal range for an extended period.
CEA, carcinoembryonic antigen.

Figure 9

Enhanced computed tomography scan of
the lesion in the left lobe of the liver post-HIFU. (A) The lesion
measured 38×33 mm at 3 months post-HIFU (arrow). (B) The lesion
measured 37×33 mm at 6 months post-HIFU (arrow). (C) The lesion
measured 35×32 mm at 18 months post-HIFU (arrow). (D) The lesion
measured 33×30 mm at 2 years post-HIFU (arrow). HIFU,
high-intensity focused ultrasound.

Figure 10

Follow-up by enhanced magnetic
resonance imaging. (A) The lesion measured 30×19 mm at 6 years
post-HIFU. At (B) 7, (C) 8, (D) 9, (E) 10 and (F) 11 years
post-high-intensity focused ultrasound, the left hepatic lobe shows
stable residual scar tissue without signs of recurrence.

Figure 11

Timeline of the patient's clinical
course. d, days; m, months; LM, liver metastasis; chemo,
chemotherapy; TACE, transarterial chemoembolization; HIFU,
high-intensity focused ultrasound; RFA, radiofrequency
ablation.
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Copy and paste a formatted citation
Spandidos Publications style
Yang Y, Zhang H, Shen Y, Yang F, Zhao D, Lin Y and Huang G: High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report. Oncol Lett 31: 98, 2026.
APA
Yang, Y., Zhang, H., Shen, Y., Yang, F., Zhao, D., Lin, Y., & Huang, G. (2026). High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report. Oncology Letters, 31, 98. https://doi.org/10.3892/ol.2026.15451
MLA
Yang, Y., Zhang, H., Shen, Y., Yang, F., Zhao, D., Lin, Y., Huang, G."High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report". Oncology Letters 31.3 (2026): 98.
Chicago
Yang, Y., Zhang, H., Shen, Y., Yang, F., Zhao, D., Lin, Y., Huang, G."High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report". Oncology Letters 31, no. 3 (2026): 98. https://doi.org/10.3892/ol.2026.15451
Copy and paste a formatted citation
x
Spandidos Publications style
Yang Y, Zhang H, Shen Y, Yang F, Zhao D, Lin Y and Huang G: High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report. Oncol Lett 31: 98, 2026.
APA
Yang, Y., Zhang, H., Shen, Y., Yang, F., Zhao, D., Lin, Y., & Huang, G. (2026). High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report. Oncology Letters, 31, 98. https://doi.org/10.3892/ol.2026.15451
MLA
Yang, Y., Zhang, H., Shen, Y., Yang, F., Zhao, D., Lin, Y., Huang, G."High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report". Oncology Letters 31.3 (2026): 98.
Chicago
Yang, Y., Zhang, H., Shen, Y., Yang, F., Zhao, D., Lin, Y., Huang, G."High‑intensity focused ultrasound in the multimodal treatment of colorectal cancer liver metastases: A case report". Oncology Letters 31, no. 3 (2026): 98. https://doi.org/10.3892/ol.2026.15451
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