The Rare Occurrence of Splenic Metastasis of Cervical Cancer: A Case Report

Abstract

Splenic metastasis of solid tumors has a low occurrence rate and an incidence of only 2.9%–9%. Given its rarity, only a few cases of splenic metastasis of cervical cancer have been reported. This report presents a case of 76-year-old woman with stage IB1, moderately differentiated adenocarcinoma of cervix, coupled with invasion of cervical stroma and cervical canal. The patient had a cancer antigen 125 (CA-125) level of 150 U/ml and was treated with hysterictomy and pelvic lymphadenectomy. She received 45 Gy pelvic radiotherapy and then 24 Gy brachytherapy. She developed abdominal pain two years later. Computed tomography (CT) examination found two solid lesions of the spleen and no lesions in the rest of the abdominal cavity and chest. Her CA-125 level increased to 2,733 U/ml. Histopathological findings showed splenic metastasis of well differentiated adenocarcinoma in cervix. Immunohistochemical tests revealed that the tumor was positive for carcinoembryonic antigen and negative for estrogen and progesterone receptors. Eight weeks after operation, CA-125 level of the patient was 16 U/ml. She received adjuvant therapy consisting of paclitaxel and cisplatin for 6 cycles. After being followed up for 12 months, the patient was still alive and had no evidence of tumor activity. The spleen is a rare metastatic site. Splenectomy is considered an appropriate treatment to prevent complications, such as splenic rupture and splenic vein thrombosis, and reduce the pain caused by splenomegaly.