Isolated metachronous splenic metastasis from synchronous colon cancer

Gençosmanoğlu, Rasim; Aker, Fügen; Kır, Gözde; Tözün, Nurdan

doi:10.1186/1477-7819-4-42

Cited by 31 publications

(30 citation statements)

References 13 publications

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“…Similarly, ovarian metastases, bone metastases, and metastatic involvement of the spleen are uncommon extrahepatic disease sites, only described in case reports or small patient series [30,31,32]. As long-term outcomes after resection of these extrahepatic disease localizations remain unknown, we recommend only performing surgical resection if it can be complete for all known intra- and extrahepatic disease sites.…”

Section: Rare Extrahepatic Disease Localizationsmentioning

confidence: 99%

Resection of Colorectal Liver Metastases with Extrahepatic Disease

Haas

Wicherts

Adam³

2008

Dig Surg

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Extrahepatic disease in combination with colorectal liver metastases has long been considered an absolute contraindication for surgery. However, in many reported series, long-term survival is achieved in selected patients with concomitant extrahepatic disease as long as the resection of all metastatic sites is complete. Owing to these results, an increasing number of patients with advanced metastatic colorectal disease are now being referred for surgery. For patients with concomitant liver and lung metastases, sequential resection of both disease sites has proven to be safe, offering a 5-year survival rate of more than 30%. On the contrary, hepatectomy combined with resection of regional lymph node metastases can only provide long-term survival in case of pedicular lymph node involvement. Furthermore, control of the disease by preoperative chemotherapy appears to be crucial. For peritoneal carcinomatosis, aggressive treatment combining cytoreductive surgery and intraperitoneal chemotherapy can offer a chance of prolonged long-term survival to selected patients with limited peritoneal extension. In conclusion, resection of both intra- and extrahepatic colorectal metastases should be considered if resection of all metastatic sites can be complete and the disease is controlled by chemotherapy. Long-term survival in these patients with advanced disease could be achieved if they are managed by experienced multidisciplinary teams.

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Section: Rare Extrahepatic Disease Localizationsmentioning

confidence: 99%

Resection of Colorectal Liver Metastases with Extrahepatic Disease

Haas

Wicherts

Adam³

2008

Dig Surg

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“…Therefore, immune surveillance appears to potently inhibit tumor cell proliferation, and the intense destruction of malignant cells in spleen may limit the development of splenic metastasis. 7 The absence of afferent lymphatics to the spleen was considered to be another reason for the low incidence of splenic metastases, 11 except in the case of secondary involvement by lymphoma. In patients with nonlymphomatous malignancies splenic metastases were infrequent, with autopsy frequencies ranging from 0.6% to 7.1%.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, hepatoid adenocarcinoma (HAC) is a rare adenocarcinoma that arises outside the liver but has the characteristics of a primary liver cancer. This neoplasm has been reported in a variety of sites including the stomach, 3,4 ovary, 5 lung, 6 colon, 7 uterus, 8 pancreas, 9 prostate, 10 and others; of these, the stomach is the most common site involved. There have so far been no reports concerning HAC in the spleen, and we herein present this unusual case with a review of the pertinent literature.…”

Section: Introductionmentioning

confidence: 98%

Metastatic splenic α-fetoprotein-producing adenocarcinoma: Report of a case

et al. 2011

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Solitary carcinomatous metastases to the spleen are rare, and the presence of solitary splenic metastasis of hepatoid adenocarcinomas (HAC) has not yet been reported. We herein present the case of a 54-year-old male patient who developed a metastatic tumor to the spleen with enhanced levels of serum α-fetoprotein and carcinoembryonic antigen (CEA). The patient underwent a gastrectomy due to adenocarcinoma of the stomach 5 years previously. The tumor was diagnosed on the grounds of histopathology and immunohistochemical staining after splenectomy. The pathology slides showed both adenocarcinoma and hepatoid structures. α-Fetoprotein antibody staining was positive in the tumor, suggesting hepatoid characteristics. After the operation, the patient recovered well and had no signs of recurrence at a follow-up examination after 9 months. Together with this case, several aspects of the disease are discussed after a review of the current literature.

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“…Splenic metastases arise in less than 1% of all metastases [2], and their most common primary sources are breast, lung, colorectal, and ovarian carcinomas in cases of multivisceral cancer [3]. Isolated solitary splenic metastases from colorectal carcinoma are a very rare clinical entity despite the fact that the spleen is the largest single mass of lymphoid tissue in the body [4,5]. When they are present, they are usually a manifestation of widely disseminated disease [6].…”

Section: Introductionmentioning

confidence: 99%

Isolated splenic metastasis from colorectal cancer

et al. 2011

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Splenic metastases are unusual, arising in less than 1% of all metastases. Isolated solitary splenic metastasis from colorectal carcinoma is considered exceptional. This rarity has been explained by several hypotheses relating to the anatomical, histological, and immunological features of the spleen. We review the reported cases of isolated solitary splenic metastasis from colorectal carcinoma and discuss the diagnostic and therapeutic options for this entity. We searched the English-language medical literature, using the Medline and Pubmed databases from January 1966 through July 2010, for articles reporting isolated splenic metastasis from colorectal carcinoma. Only 26 cases have been reported; four cases had synchronous splenic metastasis. Fifteen patients had regional lymph node involvement on diagnosis of primary carcinoma. The primary tumor was located in the left colon or in the rectum in 18 cases. Carcinoembryonic antigen (CEA) level was elevated in 73% of cases. All patients underwent curative splenectomy; only one patient had laparoscopic resection of the spleen. Mean reported survival interval was 19.5 months; only three patients were deceased at last follow-up. Solitary splenic metastasis from colorectal carcinoma is very rare; clinicians are advised to pay close attention when routinely evaluating patients with serial CEA levels and abdominal scans. Splenectomy seems to be the preferred treatment modality with improvement of long-term survival. However, definitive conclusions cannot be drawn from the small number of case reports available.

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Isolated metachronous splenic metastasis from synchronous colon cancer

Abstract: Isolated splenic metastasis is a rare finding in the follow-up of colorectal cancer patients and long-term survival can be achieved with splenectomy.

Cited by 31 publications

References 13 publications

Resection of Colorectal Liver Metastases with Extrahepatic Disease

Resection of Colorectal Liver Metastases with Extrahepatic Disease

Metastatic splenic α-fetoprotein-producing adenocarcinoma: Report of a case

Isolated splenic metastasis from colorectal cancer

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