The clinical course and management of cervical cancer with splenic metastasis: Case report and review of the literature

Abstract

Adenovirus‐mediated herpes simplex virus thymidine kinase gene therapy (ADV‐TK) in combination with interventional treatment could relieve the symptoms in patients with widespread splenic metastasis.

Splenic oligometastasis from cervical adenocarcinoma three years after disease free survival: A case report and a review of literature

“…Sixty percent of the cases were metastases from gynecological carcinomas, with the majority being ovarian and endometrial cancer as the primary tumors [ 19 ]. The most recent review published in 2020 found a total of eight cases of solitary splenic metastasis from cervical cancer in the literature where two of them were AC and the rest were SCC [ 10 ]. This could be explained by the higher prevalence of SCC compared to AC [ 2 ].…”

“…In our case the patient had complete radiological and pathological response after treatment with chemotherapy followed by brachytherapy, but she developed splenic oligometastasis afterwards. With regards to cervical cancer splenic metastasis, surgical intervention by splenectomy is the definitive treatment in case of solitary splenic metastasis [ 9 , 10 , 12 ]. However, many authors recommend adjuvant chemotherapy in isolated splenic metastasis as it is considered a form of distant metastases [ 9 , 11 ].…”

“…Disseminated metastatic disease is treated with palliative chemotherapy. Palliative surgery might be considered in case of symptomatic splenomegaly to improve the quality of life and to avoid complications such as splenic rupture, splenic vein thrombosis and painful splenomegaly [ 9 , 10 , 12 , 20 ].…”

“…Follow-up protocol should include clinical examination, vaginal cytology, tumor markers and imaging [ 9 , 15 ]. Increase in the levels of tumor markers, such as SCC antigen can predict the presence and recurrence of metastasis in 46–92% of cases six months before it can be detected clinically (range 2–7.8 months) [ 9 , 10 , 13 , 15 ]. Radiological evaluation using CT, PET and MRI is necessary in follow-ups to restage the patient and confirm recurrence [ 6 , 10 , 14 ].…”

“…Some studies reported other unusual sites of metastasis from cervical AC such as the abdominal wall, spleen, hand and orbit [ [5] , [6] , [7] , [8] ]. A limited number of studies report the metastasis of cervical cancer to the spleen, yet most of them were histopathologically found to be SCC [ [9] , [10] , [11] , [12] , [13] , [14] ]. Upon extensive literature review, we only found four cases reporting the metastasis of cervical AC to the spleen [ 6 , [15] , [16] , [17] ].…”