Solitary Splenic Metastasis from Ovarian Cancer Successfully Treated by Hand-Assisted Laparoscopic Splenectomy: Report of a Case

Yano, Hiroshi; Iwazawa, Takashi; Kinuta, Masakatsu; Nakano, Yoshiaki; Tono, Takeshi; Matsui, Shigeo; Kanoh, Toshiyuki; Monden, Takushi

doi:10.1007/s005950200142

Cited by 28 publications

(19 citation statements)

References 8 publications

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“…Concerning tumor spread at primary diagnosis, advanced disease (FIGO Stage III-IV) was observed in 20 (57.1%) cases [6,27,32,34,35,36,37,38,40,41,42,45,] whereas early disease (FIGO Stage I-II) was observed in 9 (25.7%) [5,8,31,33,39,43,44] (unknown in 6 patients). Most cases of spleen recurrence were diagnosed by CT findings or elevated levels of serum CA125.…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

Section: Discussionmentioning

confidence: 99%

“…Splenectomy was performed in all published cases. Laparoscopic approach was preferred in 9 (25.7%) cases [27,36,37,38,40]. In 5 out of them, the spleen was removed by hand-assisted laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

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

Sorbi¹,

Prosperi²,

Villanucci³

et al. 2015

Gynecol Obstet Invest

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Isolated parenchymal splenic lesions are very rare and may occur as recurrences in the form of epithelial tubo-ovarian cancer (ETOC). We report a case of solitary parenchymal splenic recurrence of ETOC, which developed 50 months after the initial treatment. A 66-year-old woman underwent laparotomic primary cytoreduction in 2008. After platinum-based chemotherapy, she developed recurrences; thus, she underwent secondary and tertiary cytoreduction in 2011 and 2012 respectively. In April 2013, CT scan documented a solitary parenchymal splenic lesion and it was confirmed by FDG PET/CT. She underwent quaternary cytoreduction by laparoscopic splenectomy. Histopathological evaluation revealed metastatic parenchymal disease consistent with recurrent ETOC. She was alive and disease-free for ten months since splenectomy. In literature there are 35 cases of isolated spleen parenchymal metastasis of ETOC and our report is the first case of laparoscopic splenectomy in the setting of quaternary cytoreduction. Laparoscopic splenectomy as quaternary cytoreduction is safe and feasible and could be congruent to the well-established experiences already reported for the primary, secondary or even tertiary cytoreduction where the absence of residual disease has been translated in a significant survival benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Sorbi¹,

Prosperi²,

Villanucci³

et al. 2015

Gynecol Obstet Invest

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“…A number of authors have reported that the laparoscopic splenectomy is technically safe, with several advantages over open splenectomy [29, 30, 31, 32]. HALS [10, 11, 33, 34]has developed as an advanced laparoscopic technique because use of the hand allows for easy exposure, complete exploration, meticulous dissection, and immediate hemostasis. It also allows precise localization of the splenic artery and the mobilization of the posterior face of the spleen.…”

Section: Discussionmentioning

confidence: 99%

Hand-Assisted Laparoscopic Splenectomy for Splenic Tumors

Yano¹,

Nakano²,

Tono³

et al. 2004

Dig Surg

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Background: The feasibility of hand-assisted laparoscopic splenectomy (HALS) for splenic tumors including benign or malignant neoplasms and the associated clinical outcome of the patients remain unclear. Methods: A total of 10 patients with splenic tumors undergoing HALS were retrospectively analyzed in this study. The intraoperative course, postoperative course, and postoperative recovery were evaluated. Results: Ten patients with splenic tumors consisted of 5 with benign tumors and 5 with malignant tumors. HALS was not converted to an open splenectomy in any of the patients. Mean operative time was 170 min (range 100–310 min). Mean estimated blood loss was 105 g (range 10–900 g). Mean splenic size and splenic weight was 13 cm and 478 g, respectively. Splenomegaly based on size or weight occurred in 50% of the patients. There were no intra- or postoperative complications. Postoperative chemotherapy was given to 4 patients with malignant tumors including metastatic carcinomas and malignant lymphomas. All the patients were alive at a mean follow-up of 26 months, ranging from 15 to 43 months after surgery. There was no port-site recurrence after surgery in our study. Mean time to first flatus, mean time to first walking, mean time to resumption of oral intake, mean length of hospital stay, and mean duration of epidural analgesia were 1.8, 1, 1.5, 10.8 and 3.1 days, respectively. The results were equal in terms of intra- and postoperative course to those seen with a standard laparoscopic splenectomy for 13 patients with idiopathic thrombocytopenic purpura. Conclusion: HALS may be a good indication for malignant tumors as well as benign tumors of the spleen.

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“…The most common malignant tumor of the spleen is lymphoma [1]. Other less common malignancies include primary splenic angiosarcoma, or metastases from nongastrointestinal malignancies [2][3][4][5][6].…”

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confidence: 99%