Abstract
BackgroundThe occurrence of sarcoid reactions has been recognized in various cancers. The common location for observing these granulomas is mainly the lymph nodes, but a rare occurrence in the spleen has been reported.Almost all splenic sarcoid reactions associated with gastric cancer have been resected synchronously and diagnosed accidentally, and a rare metachronous occurrence of a sarcoid reaction in the spleen after distal gastrectomy can mimic cancer metastasis. We describe a rare case of a splenic sarcoid reaction recognized in a patient with gastric cancer 6 months after distal gastrectomy.Case presentationAn 82-year-old man underwent laparoscopic distal gastrectomy for gastric cancer (T3N0M0, stage IIA). Six months after gastrectomy, CT and 18F-fluorodeoxyglucose (FDG)-PET/CT showed the appearance of a splenic mass. We diagnosed solitary splenic metastasis from gastric cancer and performed laparoscopic-assisted splenectomy. His splenic tumor was diagnosed as a sarcoid reaction by histopathological examination.ConclusionTo our knowledge, this is the first report of a splenic sarcoid reaction recognized 6 months after distal gastrectomy for gastric cancer without any chemotherapy. The splenic sarcoid reaction and cancer metastasis to the spleen were undistinguishable from the CT and FDG-PET/CT findings. The present case and literature review showed that cases of splenic sarcoid reactions associated with gastric cancer can also be accompanied by the occurrence of these granulomas in lymph nodes. When the appearance of a solitary mass is observed in the spleen after resection of primary cancer, it is necessary to consider not only cancer metastasis but also sarcoid reactions. Retrospective histopathological confirmation of the existence of sarcoid reactions in lymph nodes from resected specimens might possibly avoid incorrect diagnosis and intervention.
Highlights
The occurrence of sarcoid reactions has been recognized in various cancers
The splenic sarcoid reaction and cancer metastasis to the spleen were undistinguishable from the computed tomography (CT) and FDG-positron emission tomography (PET)/CT findings
The present case and literature review showed that cases of splenic sarcoid reactions associated with gastric cancer can be accompanied by the occurrence of these granulomas in lymph nodes
Summary
We present a rare case of a splenic sarcoid reaction recognized 6 months after distal gastrectomy for gastric cancer without any chemotherapy. Splenic sarcoid reactions and cancer metastasis to the spleen are undistinguishable from CT and FDG-PET findings. Our case and literature review showed that cases of splenic sarcoid reactions occur in the lymph nodes. When the appearance of a solitary mass is observed in the spleen after gastrectomy in gastric cancer patients, it is necessary to consider cancer metastasis and sarcoid reactions. Retrospective histopathological confirmation of the existence of a sarcoid reaction in the lymph nodes from the resected specimen would be helpful for optimal diagnosis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
