Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

Hu, Li; Zhu, Jiang; Lei, Fang; Yu, Xiuchong; Yan, Zhilong

doi:10.12998/wjcc.v8.i15.3320

Cited by 7 publications

(16 citation statements)

References 34 publications

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“…В доступной литературе публикации, посвященные этому вопросу, носят характер сообщений либо системного клиникопатогенетического анализа имеющихся данных [10,13,[15][16][17].…”

Section: Discussionunclassified

“…Гендерных различий в публикациях по частоте изолированного поражения селезенки практически нет [15]. Имеются лишь некие указания на преобладание лиц мужского пола.…”

Section: Discussionunclassified

“…Это касается прежде всего хронологии количества наблюдений. Так, в 2007 г. сообщается о 44 больных, в 2011 -26, в 2016 -31 пациенте, а в 2020о 34 наблюдениях [10,[13][14][15]. В связи с этим мы провели сравнительный анализ и пришли к выводу, что общее количество случаев, включая наши сообщения, по изолированному метастатическому поражению селезенки при колоректальном раке составляет 59 наблюдений.…”

Section: Discussionunclassified

“…опубликовали первое сообщение об изолированном метастазе в селезенку при колоректальном раке [8]. С тех пор палитра публикаций представлена описанием отдельных случаев и систематических обзоров уже имеющихся сообщений [9][10][11][12][13][14][15].…”

Section: Introductionunclassified

“…Так, на долю II стадии пациентов с установленным диагнозом метастатического поражения приходилось 26,9%, а III стадии -69,2%. Практически у всех больных наблюдались единичные метастазы и только лишь в одном случае -множественные [15].…”

Section: Introductionunclassified

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Isolated splenic metastases from colon cancer: clinical observations

Огнерубов

Алексеевич²,

Antipova³

et al. 2021

J. Mod. Onco.

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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.

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Section: Discussionunclassified

Section: Introductionunclassified

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Isolated splenic metastases from colon cancer: clinical observations

Огнерубов

Алексеевич²,

Antipova³

et al. 2021

J. Mod. Onco.

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Dihydropyrimidine dehydrogenase (DPYD) gene c.1627A>G A/G and G/G genotypes are risk factors for lymph node metastasis and distant metastasis of colorectal cancer

Zeng

Huang

et al. 2021

Clinical Laboratory Analysis

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Background Dihydropyrimidine dehydrogenase (DPD) acts as the key enzyme catabolizing pyrimidines, and may affect the tumor progression. DPYD gene mutations affect DPD activity. The relationship between DPYD IVS14+1G>A, c.1627A>G, c.85T>C and lymph node metastasis (LNM) and distant metastasis (DM) of colorectal cancer (CRC) was investigated. Methods A total of 537 CRC patients were enrolled in this study. DPYD polymorphisms were analyzed by polymerase chain reaction (PCR)‐Sanger sequencing. The relationship between DPYD genotypes and clinical features of patients, metastasis of CRC was analyzed. Results About DPYD c.1627A>G, A/A (57.7%) was the most common genotype, followed by A/G (35.6%), G/G (6.7%) genotypes. In c.85T>C, T/T, T/C, and C/C genotypes are accounted for 83.6%, 16.0%, and 0.4%, respectively. Logistic regression analysis revealed that DPYD c.1627A>G A/G and G/G genotypes in the dominant model (A/G + G/G vs. A/A) were significant risk factors for the LNM (p = 0.029, OR 1.506, 95% CI = 1.048–2.165) and DM (p = 0.039, OR 1.588, 95% CI = 1.041–2.423) of CRC. In addition, DPYD c.1627A>G polymorphism was more common in patients with abnormal serum carcinoembryonic antigen (CEA) (>5 ng/ml) (p = 0.003) or carbohydrate antigen 24–2 (CA24‐2) (>20 U/ml) level (p = 0.015). Conclusions The results suggested that DPYD c.1627A>G A/G, G/G genotypes are associated with increased risk of LNM and DM of CRC.

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