Spontaneous rupture of the spleen secondary to metastatic carcinoma

Gupta, Pankaj; Harvey, L.

doi:10.1002/bjs.1800800522

Cited by 27 publications

(9 citation statements)

References 5 publications

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“…However, the differentiation between benign and malignant splenic focal lesions can be difficult using these techniques, and an 18F-FDG scan is often performed [ 1 , 9 , 46 ]. A positive history of cancer appeared as the only independent predictive factor for malignancy of a splenic lesion [ 9 ], and this is consistent with our case report and with the current literature [ 3 , 10 , 14 , 41 – 45 ] Generally, in patients with a history of malignancy, a solitary splenic lesion should be first considered as a metastases [ 10 ]. In these patients, a histologic diagnosis should be achieved by percutaneous biopsy or splenectomy [ 1 , 47 – 49 ].…”

Section: Discussionsupporting

confidence: 90%

“…In most of the cases, splenic metastases are diagnosed incidentally in asymptomatic patients. However, splenic metastases, especially the isolated ones, may also occur in association with non-specific clinical manifestations, such as fatigue, weight loss and fever; anemia or thrombocytopenia caused by hypersplenism; pain in the left upper abdominal quadrant; splenomegaly or spontaneous splenic rupture [ 3 , 10 , 14 , 41 – 45 ]. Symptomatic lesions are more frequently reported in women and in younger patients, and the mean maximum size of the lesions in these patients is usually larger than in asymptomatic patients [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Solitary splenic metastasis from nasopharyngeal carcinoma: a case report and systematic review of the literature

et al. 2016

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BackgroundSolitary splenic metastases are a rare occurrence, and the nasopharyngeal carcinoma represents one of the most uncommon primary sources. The present study aimed to describe a rare case of a solitary single splenic metastasis from nasopharyngeal carcinoma and to assess the number of cases of isolated nasopharyngeal carcinoma metastases to the spleen reported in the literature.Main bodyWe describe the case of a 56-year-old man with a history of nasopharyngeal carcinoma and complete remission after chemo-radiotherapy. Three months after complete remission, positron emission tomography/computed tomography scan revealed a hypermetabolic splenic lesion without increased metabolic activity in other areas. After laparoscopic splenectomy, the pathology report confirmed a single splenic metastasis from undifferentiated carcinoma of the nasopharyngeal type. The postoperative period was uneventful. We also performed a systematic review of the literature using MEDLINE and Google Scholar databases. All articles reporting cases of splenic metastases from nasopharyngeal carcinoma, with or without histologic confirmation, were evaluated. The literature search yielded 15 relevant articles, which were very heterogeneous in their aims and methods and described only 25 cases of splenic metastases from nasopharyngeal carcinoma.ConclusionThe present review shows that solitary splenic metastases from nasopharyngeal carcinoma are a rare event, but it should be considered in patients presenting with splenic lesions at imaging and a history of primary or recurrent nasopharyngeal carcinoma. No evidence supports a negative impact of splenectomy in patients with solitary splenic metastasis from nasopharyngeal carcinoma.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Solitary splenic metastasis from nasopharyngeal carcinoma: a case report and systematic review of the literature

et al. 2016

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“…However in our patient, the primary lung cancer was in the right lung. Among the previous cases, only one was found to have the primary lesion in the right-hand side [9]. As shown in table 1, the most frequent histological type of lung cancer with isolated splenic metastasis is adenocarcinoma …”

Section: Discussionmentioning

confidence: 93%

“…Therefore, isolated splenic metastasis of primary lung cancer is exceedingly rare. To date, only 11 cases have been reported in published literature (table 1) [3,4,[6][7][8][9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Isolated splenic metastasis from lung cancer: ringleader of continuous fever

Tang¹,

Huang²,

Xiu³

et al. 2010

European Respiratory Review

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The spleen is an infrequent metastatic organ of solid tumours, the prevalence of which ranges between 2.3% and 7.1% in populations with cancer as determined through autopsy. The most common sources of metastasis are breast, lung, colorectal and ovarian carcinoma and melanoma. Isolated metastasis of the spleen is rarely reported with only 93 cases from all sources having been reported up to 2007. Therefore, isolated splenic metastasis from primary lung cancer is exceedingly rare with only 11 cases reported to date.Herein, we report a rare case of isolated splenic metastasis in a 49-yr-old female 3 months after lobectomy for an undifferentiated large cell carcinoma in the right lung (pT 2a N 0 M 0 ). The only symptom the patient presented with was continuous high fever, which had never been previously reported. This patient presented diagnostic challenges due to the presentation of high fever, leukoapenia after chemotherapy and the cystic splenic mass, all of which led to the initial consideration of splenic abscess. The patient's high fever resolved rapidly after splenectomy and splenic metastasis was confirmed by pathological findings.We also reviewed all 11 reported previously cases and summarised the characteristics and appropriate management of isolated splenic metastasis from lung cancer.KEYWORDS: Fever, lung cancer, splenectomy, splenic metastasis ). Although the chemotherapy was thought to be responsible for myelosuppression and a secondary infection, no other symptoms existed to indicate the site of infection. The patient was admitted and treated with granulocyte colonystimulating factors and antibiotics. However, even though strong, broad spectrum anti-infection strategies were administered and the WBC recovered the patient's high fever was not resolved. Surprisingly, the abdominal ultrasonic inspection revealed a solid, cystic mass in the spleen 8.268.1 cm in size. A further abdominal CT scan also showed a 9.568.0 cm splenic mass with complex solid and cystic components ( fig. 1b). Splenic abscess was initially considered due to the manifestation of high fever only. However, percutaneous splenic puncture guided by ultrasound showed little fluid, which was cultured with no bacteria. Due to her history of lung cancer, splenic metastasis was considered; however, a chest CT

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“…Agha-Mohammadi et al found that only 21% of patients presented with symptoms of pain, splenomegaly, or weight loss.78 In contrast, there have been dramatic reports of spontaneous splenic rupture from tumor burden, with a high morbidity rate. 83,84 In most patients, splenic involvementis detected through routine follow-up imaging. The challenge for the clinician is to discern the relatively rare finding of splenic metastasis from the more common primary splenic pathology, such as abscess, hemangioma, or infarct.85 Imaging, tumor markers, and FNA all are used to diagnose splenic lesions,with acceptable risks.86 When an isolated metastasis is confirmed, most investigators agree that a splenectomy should be performed to prevent further metastatic seeding and to avoid possible splenic rupture.…”

Section: Metastatic Disease To the Spleenmentioning

confidence: 99%