Figure 1:

A 61-year-old male patient presented with extensive metastatic disease to the liver from rectal cancer.

After 3 months of FOLFOX/bevazicumab treatment and sufficient downsizing of liver metastases, the patient underwent explorative laparotomy. Due to steatosis and preoperative chemotherapy, right hemihepatectomy with resection of segment 4b was considered too dangerous, and atypical resection of several metastases in the left liver (A, arrow) and ligation of the right portal vein was performed. Postoperatively, chemotherapy was continued. CT scan 5 months later demonstrates the hypertrophy of the left lateral sector (B and D, double arrows), and the TSH was completed by a formal right hemihepatectomy. Postoperative CT control 3 months later shows a tumor-free left liver. (E) Portal venous embolization (F) in another patient with CRC liver metastases achieves a similar amount of hypertrophy (white arrows, left portal vein; red arrows, embolized right branches).