12th May 2024

A 68-year-old woman presents with a six-month history of altered bowel habits, rectal bleeding, and significant unintentional weight loss.

A 68-year-old woman presents with a six-month history of altered bowel habits, rectal bleeding, and significant unintentional weight loss. She has a family history of Lynch syndrome. Colonoscopy reveals a large mass in the descending colon, and biopsy confirms adenocarcinoma. Subsequent CT imaging shows multiple lesions in the liver.

Which is the most likely route by which this tumour spread to the liver?