Solitary Splenic Metastasis Research Articles

Early solitary splenic metastasis from adenocarcinoma of kidney

Early solitary splenic metastasis from adenocarcinoma of kidney

SOLITARY SPLENIC METASTASIS FROM COLON CARCINOMA-REPORT OF TWO CASES-

Two cases of splenic metastasis from colon carcinoma without other organ metastasis are reported. Patient 1 was a 76-year-old man, who underwent a right hemicolectomy for ascending colon carmcinoma. Twenty two months later, a splenectomy and partial resection of the pancreas were performed for solitary metastasis to the spleen. He was alive with local recurrence 25 months after the second operation. Patient 2 was a 74-year-old man, who underwent a right hemicolectomy for ascending colon carcinoma. One year later, a splenectomy and caudal pancreatectomy was performed for solitary splenic metastasis from the ascending colon carcinoma. He was alive with no evidence of recurrence 5 months after the second operation. In both patient 1 and 2, the histological diagnoses of both the colon and splenic tumors were the same. Splenic metastasis after a colorectal carcinoma operation is rare. Only 30 cases including ours have been reported in Japan. Most splenic metastases occurred within 1 year after the colorectal operation, and prognosis was poor. Micrometastasis to the spleen might have already occurred at the time of operation for colorectal carcinoma, therefore, intensive chemotherapy after operation is recommended for splenic metastasis from colorectal carcinoma.

A CASE OF METACHRONOUS SOLITARY SPLENIC METASTASIS FROM SIGMOID COLON CANCER

A 60-year-old woman, who was followed in the outpatient clinic after a sigmoidectomy for advanced cancer of the sigmoid colon on November 19, 1992, was admitted to the hospital because of metachronous solitay metastasis in the spleen. She underwent a splenectomy on June 12, 1994. After the operation she had been administered anticancer drug perosly on an ambulant basis. But she died of live failure due to multiple liver metastasis 15 months after the reoperation. Splenic metastasis from colorectal cancer is extremely rare. It is believed that metachronous solitary splenic metastasis, that is seen only in the spleen with lapse of over a year after the first procedure, may have a good prognosis. However, there are some cases with poor prognosis, like our case. Although the splenectomy must be an effective therapy for them. it is important to detect splenic metastasis as soon as possible for improving the prognosis. And we must be careful not only for local recurrence, liver metastasis, and lung metastasis but also for possible splenic metastasis after operation for colorectal cancer.

RESECTED SOLITARY SPLENIC METASTASIS 2 YEARS AFTER EARLY COLONIC CARCINOMA IN ONE ADULT

We report a resected case of solitary splenic metastasis after polypectomy of early sigmoid colon cancer two years before. The patient was an 82-year-old woman. She had under gone an endoscopic polypectomy for a sigmoid lp typed polypoid lesion at another hospital in October 1994. Histologically, Diagnosis was moderately differentiated adenocarcinoma invading the submnucosa (sm 2, ly 1, v 1, ce [-]). An additional resection was recommended, but she refused and had been followed-up carefilly. She was seen at our hospital because of urological symptoms in October 1996. An abdominal ultrasonography and a computed tomography showed a 3cm tumor of the spleen. The serum lactase dehydrogenase (LDH) level was slightly elevated, Ga scintigraphy revealed a slight accumulation in the spleen and no abnormality in any other organ. A preoperative diagnosis of primary tumor of the spleen was made and laparoscopic splenectomy was performed. Histopathological findings of the resected splenic tumor detected the same histological type as the early sigmoid polypoid carcinpma. Therefore, a diognosis was determined of metastasis of the early sigmoid colon carcinoma to the spleen without any other distant metastases. This case was unique in that the tumor of early stage colon cancer resulted in splenic metastasis in two years.

TWO CASES OF SOLITARY SPLENIC METASTASIS FROM COLONIC CANCER

This paper reports two patients who had a splenectomy for solitary splenic metastasis of colonic cancer. Patient 1, a 56-year-old woman, underwent a right hemicolectomy and a cholecystectomyfor gallstones and a cecal cancer (moderately differentiated adenocarcinoma. P0, H0, se, n2, 1y3, v, stage IIIb) on August 12, 1992. Eightmonths late a Splenectomy was performed for a solitary metastasis to the spleen. She died of carcinomatous peritonitis 13 months after the splenectomy. Patient 2 was a 51-year-old woman. She underwent a sigmoidectomy for a cancer of the sigmoid colon (moderately differentiated adenocarcinoma. P0. H0, sm, n0, ly0, v0 stage I) in October 1993. Three years and 8 months after the sigmodectomy a splenectomy was performed. She subsequently developed multiple interperitoneal metastases, and is being followed as an outpatient. Both of these patients who underwent splenectomy for solitary metastasis to the spleen subsequently developed metastases to the multiple organs. It is thought that the prognosis after splenectomy can not be favorable in such patients.

A CASE OF SOLITARY RESECTED SPLENIC METASTASIS AFTER HEPATECTOMY FOR HEPATOCELLULAR CARCINOMA

We experienced a case of solitary splenic metastasis after hepatectomy for hepatocelluler carcinoma. The case was a 69-years-old female without liver cirrhosis or hepatitis. She underwent “so called Right Liver Trisegmentectomy” for large hepatic tumor on November 16, 1993. Pathological findings revealed trabecular type moderately differentiated hepatocellular carcinoma. fc (+), fc-inf (+), Vp0, Vv0, b0, tw (-), im 1. Seven months later, we observed multiple liver metastasis and a low density splenic tumor of 2cm diameter by computed tomography. We perfomed Trans arterial embolization on the liver metastasis, but the splenic tumor had enlaged to 4cm diameter. We diagnosed the splenic tumor as metastasis of hepatocellular carcinoma. She underwent splenectomy on March 20, 1995. Before and during the operation, we found other evidence of metastatic tumors except for those detected in the liver and spleen. Immunological competence levels were within the normal range. There had been 8 cases of solitary splenic metastasis of hepatocellular carcinoma reported in Japan, and only 2 were resected.

Management of a solitary splenic metastasis in the tubal carcinoma —a case report with review of the literature —

Management of a solitary splenic metastasis in the tubal carcinoma —a case report with review of the literature —

Solitary splenic metastasis of a carcinoid tumor of the lung eight years postoperatively

The case of a 49-year-old male who was found to have a solitary splenic metastasis 8 years after undergoing right upper lobectomy for Stage 1 (pT1N0M0) bronchopulmonary carcinoid tumor and was treated by splenectomy is reported. Metastasis of bronchopulmonary carcinoid tumors to the spleen is very rare. However, it is important to bear in mind that there are patients with solitary splenic metastasis who have a favorable outcome.J. Surg. Oncol.1998;67:47–48.©1998 Wiley-Liss, Inc.

Solitary splenic metastasis from colorectal carcinoma

Solitary splenic metastasis from colorectal carcinoma

Solitary splenic metastasis from colorectal carcinoma

Metastatic carcinoma that involves the spleen is usually a manifestation of widely disseminated disease involving multiple organs'. There are only four other cases of solitary splenic metastasis in the British literature2,3.

A CASE REPORT OF RESECTED SOLITARY SPLENIC METASTASIS WITH SUBCAPSULAR BLEEDING FROM COLONIC CARCINOMA

There are 30 reports on colonic carcinoma with splenic metastasis in the Japanese literature and the hematogeneous route of splenic metastasis has been suggested. We report a case of resected solitary splenic metastasis with subcapsular bleeding after resection of carcinoma of the descending colon. A 76-year-old male underwent resection of a pulmonary tumor in the left lobe on March 14, 1994 and right hemicolectomy for carcinoma of the descending colon on April 20, 1994. Histology revealed well differentiated adenocarcinoma of the colon with pulmonary metastasis, judged to be stage IV (ss, n1(+), P0, H0, M(+)), as proposed by the Japanese Colorectal Society. The serum CEA level rose again, reaching 7.3ng/ml six months later. Results of abdominal computed tomography showed a splenic tumor, 4.0×3.0cm in diameter. Ultrasonography revealed the tumor to have a round mosaic echoic area pattern. He rejected splenectomy for the metastatic lesion. Sudden left upper abdominal pain developed on September 5, 1995. Computed tomography and ultrasonography showed rupture of the splenic tumor with subcapsular bleeding. The patient thus accepted operation. A splenectomy was performed on September 25, 1995. Histological findings of the resected splenic tumor revealed the same histological type as the primary colonic lesion.

Splenic metastasis from lung cancer

Splenic metastasis from lung cancer is a rare clinical event, most often diagnosed at the time of autopsy. We report 2 cases of splenic metastasis with a primary lung cancer. The first case was a 76-year-old man presenting with a recurrent solitary splenic metastasis 14 months after surgical removal of a squamous cell carcinoma of the lung. The second patient was a 72-year-old woman who had a poorly differentiated carcinoma of the lung and multiple abdominal metastasis. We also investigated 267 autopsy cases of lung cancer from 1975 to 1992. Histologically, there were 73 cases of squamous cell carcinoma, 123 adenocarcinoma, 29 large cell carcinoma, 36 small cell carcinoma, and 7 other miscellaneous tumours. The number of splenic metastasis from lung cancer in these cases was 15 (5.6%). Splenic metastasis from a primary cancer of the left lung was more frequent than that from the right lung. Nine of 15 splenic metastases were smaller than 1 cm in size. Splenic metastasis was associated with liver and pancreas metastasis. All 15 autopsy cases with splenic metastasis from lung cancer had other abdominal organ metastasis. Our analysis indicates that a solitary splenic metastasis is rare. Selection of a suitable therapeutic approach is important.

A CASE OF SOLITARY SPLENIC METASTASIS FROM OVARIAN CANCER

Splenic tumors irrespective of primary or metastatic lesion, are relatively rare and above all solitary splenic metastasis is very rate. This paper reports a case of solitary metastasis to the spleen following oophorectomy for an ovarian cancer. A 70-year-old woman with a previous history of operation for an ovarian cancer 5 years before was found having a splenic metastasis with elevated level of CA-125. The patient is alive 3 years after splenectomy. Splenic metastasis of carcinoma is often found as a part of general metastasis, mainly due to hematogenous metastasis with grave prognosis. In cases of solitary delayed metastasis, however, good results are not in frequently obtained following surgical treatment. Therefore, splenctomy should be indicated to treat patients with sollitary tumor metastasis to the spleen.

Solitary Splenic Metastasis from Cecal Cancer

Solitary splenic metastasis of a malignant tumor is very rare. The patient reported here had cecal cancer metastasizing only to the spleen 6 years after colectomy. The patient underwent splenectomy, and at the time of writing, 58 months after the operation, he was alive without recurrence. This is the third report of a patient who had solitary splenic metastasis incidental to colorectal caner. From this experience, it may be assumed that control of the spleen might well be important in patients who undergo surgery for cancer. Presence of solitary metastasis in the spleen is an indication for splenectomy.

A CASE OF SURGICAL TREATMENT OF SOLITARY SPLENIC METASTASIS AFTER A CURATIVE RESECTION OF EARLY GASTRIC CANCER

This paper describes a case of solitary splenic metastasis 2 years and 9 months after curative resection of an early gastric cancer, which was treated by splenectomy.A 63-year-old man was seen at the hospital because of a fever and left abdominal pain. Ultrasonography, computed tomography and angiography, splenic abscess and splenic tumor revealed. Splenectomy was performed. No hepatic metastasis, lymph node metastasis or peritoneal dissemination was observed. The surgical specimen exhibited a tumor in a size of 5×4.5 cm in the splenic parenchyma, and histopathological findings proved the lesion to be well differentiated adenocarcinoma. The histopathological image closely resemmbled that of the early gastic cancer excised 2 years and 9 months before. It was diagnosed as metastasis of the gastric cancer into the spleen. Splenic metastasis can be seen at times in a state associated with multiple metastatic lesions in terminal cancers, but solitary splenic metastasis is rare. Particularly the splenic lesion metastasized from gastrointestinal cancer for which splenectomy was successfully performed is so rare that only 12 cases have been reported in Japan as far as we can review. Among the 12 cases no other case of splenic metastasis from an early cancer can not be seen.

Solitary Splenic Metastasis of an Adenocarcinoma of the Lung

Splenic metastasis of solid tumors is a rare event, most often diagnosed at the time of autopsy. Whereas in cases of widely disseminated cancer, splenic involvement may be fairly common, solitary splenic metastasis in the absence of other metastases is exceedingly rare. The authors report a case of a 63-year-old woman in whom the sole detectable distant metastasis of a lung carcinoma was a splenic mass. The splenic lesion was detected before the resection of the primary lung lesion during a complete metastatic work-up. At that time, however, it was considered unlikely that the mass in the spleen represented a metastasis because of the lack of metastatic disease elsewhere.