A 71-year-old man was referred to our hospital for a rectal tumor found by a colonoscopy. Further examinations recealed rectal adenocarcinoma with liver metastasis (cT4aN2aM1a, cStage IVa). After neoadjuvant chemotherapy, he underwent low anterior resection of the rectum with ileostomy, followed by postoperative adjuvant chemotherapy. After confirming reduction of the hepatic tumor without the appearance of new metastatic lesions, resection of the hepatic tumor and closure of the ileostomy were

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... performed. Histologically, the tumor lacked evidence of metastatic rectal cancer and consisted of numerous small vessels in fibrous stroma with hyalinization, indicative of a sclerosing hemangioma. This case of hepatic sclerosing hemangioma was radiologically difficult to differentiate from liver metastasis of rectal cancer.