Isolated splenic metastases from colon cancer: clinical observations

Isolated splenic metastases from colorectal cancer after radical surgical treatment are quite rare. This frequency of metastases is explained by the anatomical, functional and immunological characteristics of the spleen. The literature usually describes single clinical cases followed by accompanied systematic analysis and discussion. Most of the cases are asymptomatic and are accidentally diagnosed, during different types of imaging tests, including increased levels of tumor markers. The progression free survival was 3 144 months after surgical treatment of the primary tumor in most of the patients. By the nature of the lesion, metastases can be synchronous and metachronous, as well as solitary and multiple. Aim. To discuss two clinical observations of isolated splenic metastases in patients after left colic flexure cancer surgical treatment. Materials and methods. We observed 2 female patients, 68 and 70 years old, with isolated splenic metastatic after left colic flexure cancer radical surgical treatment. Results. Both cases are considered to be metachronous and the interval of absence of disease manifestations are 21 and 10 months, respectively. The patients with stage IIB and IIC left colic flexure cancer underwent left hemicolectomy followed by adjuvant polychemotherapy using regimen with 6 cycles of FOLFOX. The histological study revealed a moderately differentiated adenocarcinoma with invasion into all layers of the wall and into the surrounding tissue. There were no lymph node metastases. In the course of dynamic observation, during the next examination with the help of ultrasound examination we revealed splenic metastasis, and confirmed this using positron emission tomography/computed tomography. The disease was without clinical picture. The time interval after the surgery before diagnosis was 21 and 10 months, respectively. Surgery was performed in the volume of splenectomy. Isolated splenic metastases in the absence of other manifestations of the disease were found intraoperatively. The histological study showed the splenic metastasis of the same type of cancer as the primary tumor. The polychemotherapy using regimen with 6 cycles of XELOX was performed during the postoperative period. Patients are alive without signs of the disease over the period of 5 and 26 months, respectively. Conclusion. Isolated splenic metastases are extremely rare, more often when the primary tumor is located in the left side of the colon. The showed cases illustrate the need and importance of the monitoring the patients after surgical treatment for colon cancer. The use of positron emission tomography/computed tomography helps to understand the real prevalence of the tumor process, without using invasive methods. The surgery in the volume of splenectomy followed by chemotherapy are the main therapeutic options. In one clinical case, the metastases were multiple, and in the other one was solitary metastasis. Patients are alive without signs of the disease over the period of 5 and 26 months, respectively.

Splenic metastasis from recurrent chromophobe renal cell carcinoma 12 years post-nephrectomy: a case report

Background Renal cell carcinoma metastases to the spleen are rare. At the time of this report, only 20 cases of splenic metastases from RCC have been published in the literature. To our knowledge, our report is the first splenic metastasis from a chromophobe RCC. Case presentation A 44-year-old woman presented with clinical and radiological features of splenic metastasis from RCC, 12 years after radical nephrectomy for chromophobe RCC. Computed tomography, laparotomy and splenectomy revealed metastases to the spleen and retroperitoneal lymph nodes. Conclusion Splenic metastasis from RCC is uncommon, and rarer still from a chromophobe subtype of RCC. Surgical management of the metastasis is recommended.

Isolated Synchronous Multiple Splenic Metastases From Rectal Cancer: a Case Report and Review of the Literature

Background: Isolated splenic metastasis emanating from colorectal cancer is an extremely rare finding, which usually indicates widely disseminated and multiple metastatic cancer. There have only been 39 cases of isolated splenic metastasis reported in the English literature to date. Case presentation: We report a case of synchronous and isolated multiple splenic metastases derived from rectal cancer. An 84-year-old woman, who presented with and an increased serum carcinoembryonic antigen (CEA) level, was diagnosed with rectal cancer with splenic metastases by abdomen computed tomography (CT). The patient underwent a radical resection of rectal cancer and splenectomy, and the postoperative histopathology confirmed that the splenic lesions were derived from the adenocarcinoma of the rectum. After surgery, the patient recovered well and was recommended for further chemotherapy. Conclusion: Our findings enrich the database of this rare clinical entity and provide experience in the management of splenic metastasis. In addition to revealing a rare case, we also performed a literature review, including a brief discussion about the atypical isolated splenic metastasis from colorectal cancer (CRC).

Isolated Splenic Metastases from Renal Cell Carcinoma 11 Years after Surgery

Splenic metastases are rare and usually occur in cases of disseminated disease. We report a case of a patient who had isolated splenic metastases with a previous history of left nephrectomy due to a renal cell carcinoma 11 years before. The aim of this report is to describe the case and review the literature of isolated splenic metastases due to renal carcinoma. This case emphasizes the importance of considering splenic metastatic disease even after many years of diagnosis of renal cell carcinoma.

Laparoscopic Splenectomy for Splenic Metastasis from Primary Lung Carcinoma

Introduction. Isolated splenic metastases are a rare finding. Though several primary tumors can produce splenic metastases, including lung carcinoma, there are very few documented cases of isolated splenic metastases from lung carcinoma. This report presents such a case in which the splenic metastasis was removed with laparoscopic splenectomy. Presentation of Case. A 69-year-old woman with a history of lung carcinoma presented with several months of abdominal pain. Abdominal CT identified a splenic mass which was resected laparoscopically. Pathology confirmed a splenic metastasis from a primary large cell lung carcinoma. Discussion. Due to its anatomical and physiological characteristics, the spleen is a well-protected organ with respect to metastatic spread. The rarity of such metastases means that there is no evidence-based form of management. This case presents this rare metastatic occurrence and the successful management of the disease via laparoscopic splenectomy. Conclusions. This case confirms that splenic metastases can result from a primary lung carcinoma. Furthermore, the case supports successful management of this pathology by laparoscopic splenectomy.