Colorectal cancer can remain asymptomatic for years. Frequently sympto
ms develop insidiously and may often remain unnoticed for long periods
, even in the presence of disseminated disease. We herein report an un
usual case of a patient with carcinoma of the sigmoid colon and multip
le liver metastases. The diagnosis was established only after the pati
ent was operated on for a targe colloid nodule, a single microscopic m
etastatic focus being noticed in the histologic sections. The differen
tial diagnosis compared with the columnar type of papillary carcinoma
is discussed.