Isolated splenic metastasis of colon cancer: a case report and literature review

Abstract

Rosa N, Martins S, Lamelas J. Isolated splenic metastasis of colon cancer: a case report and literature review. J Coloproctol, 2012;32(1): 89-94. AbstRACt:Colorectal cancer (CRC) is a leading cause of death in the elderly and about 20% of these patients present metastasis at diagnosis, most often in the liver. Other common metastatic sites include: lung, bone and brain. Isolated splenic metastases are rare, and they are usually a sign of widespread disease. The authors report a case of the rare occurrence of synchronous isolated splenic metastasis, diagnosed by computed tomography in the preoperative staging of a patient with CRC.Keywords: colorectal cancer; metastatic disease; splenic metastasis.Resumo: O câncer colorretal (CCR) é uma das principais causas de morte na população geriátrica, aproximadamente, 20% desses pacientes já apresentam, na altura do diagnóstico, metástase neoplásica, mais frequentemente hepática. Outros locais comuns de metastização incluem: pulmão, ossos e cérebro. As metástases esplênicas isoladas de CCR são raras, sendo habitualmente sinal de doença generalizada. Os autores relatam um caso clínico da ocorrência rara de metástases esplênicas isoladas síncronas, diagnosticadas através da tomografia computadorizada durante o estadiamento pré-operatório de um doente com CCR.Palavras-chave: câncer colorretal; metástase neoplásica; metástases esplênicas.

Isolated splenic metastasis from a thymic carcinoma: A case report

“…Rhythmic contractions of the spleen force the blood flow from the sinusoids to the splenic veins, which, in case of constant blood flow, could prevent tumor fixation. 16 In addition, the spleen, which includes amount of lymphocytes and macrophagocytes, serves the immune function to inhibit the induction and growth of tumor cells. 17 Splenic metastasis primary from thymic carcinoma is quite uncommon.…”

Solitary Splenic Metastasis from a Mucinous Adenocarcinoma of the Cecum. A Case Report

“…Such cases occur largely in relation to lung primary tumors, endometrium, ovary, cervix, stomach, colon, breast, bladder, and skin. Approximately 60 % of cases are associated with gynecological cancers, with colorectal carcinoma as the primary location representing about 11 % of the reported cases [3]. However, cases of spleen solitary metastasis, that is, with no disease of the liver, lung, or axial skeleton, are rare [1].…”

“…Another hypothesis includes the evident acute angulation at the emergence level of the splenic artery at its origin in the celiac trunk, which can act as an anatomical obstruction of tumor emboli to the spleen. In addition, rhythmic contractions of the spleen force the blood flow from the sinusoids to the splenic veins, which, in cases of constant blood flow, could prevent tumor fixation [3]. Furthermore, it is hypothesized that the spleen produces an angiogenesis factor (angistatine) making it immune to metastasis compared with other organs [8], although other authors argue that neoplastic cells can reach the splenic vein and thus the splenic parenchyma through the inferior mesenteric vein.…”

“…The reported incidence of splenic secondaries caused by colorectal neoplasia is approximately 4.4 %, with only 18 reported cases so far [1][2][3][4][5][6][7][8]. Most cases are asymptomatic and are usually diagnosed as incidentalomas in subsequent monitoring after a raised carcinoembryonic antigen (CEA) level [2,3]. Curative splenectomy prevents serious complications such as abscesses and bleeding, which may compromise a patient's life.…”

Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

“…Searching the literature database (PubMed, Embase, Medscape) using the criteria of recurrence, solitary, splenic, ovarian cancer and tubal cancer and the references of retrieved articles, we found 35 cases of splenectomy for recurrent TOC (table 1) [5,6,8,26,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44]. Splenectomy was mainly part of secondary cytoreductive surgery and only in one case of tertiary cytoreduction [43].…”