Unusual Presentation of Pancreatic Mucinous Cystadenocarcinoma by Spontaneous Splenic Rupture

Patrinou, Vasiliki; Skroubis, George; Zolota, Vassiliki; Vagianos, Constantine

doi:10.1159/000051979

Cited by 12 publications

(4 citation statements)

References 12 publications

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“…However it has been investigated with limited success [7]. There has been some report that splenic rupture is associated with PDAC [1][2][3][4][5]. So far, only six cases were reported, splenic rupture was derived from splenic ischemia with cancer invasion to splenic vessels.…”

Section: Discussionmentioning

confidence: 99%

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Very Unusual Presentation of Pancreatic Cancer Revealed by Traumatic Spleen Injury

Paik¹

2012

JCT

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Accidental diagnosis of pancreatic ductal adenocarcinoma (PDAC) follow by trauma is very rare. Splenic infarction is unusual presentation of PDAC, and splenic rupture associated with PDAC has been reported in few cases so far. We present a patient with PDAC revealed by splenic laceration after blunt abdominal trauma. The 64-year-old patient visited emergency center with left flank pain derived from slipping down on the floor. The patient was diagnosed with splenic rupture, and was intended to perform urgent splenectomy. During operation, distal pancreas was resected with spleen due to possible severe chronic pancreatitis. However, he was diagnosed as having pancreas tail cancer with remnant cancer on the resected margin. We performed radiacal antegrade modular pancreatectomy (RAMPS) seven days after initial operation. We present a case of pancreatic tail adenocarcinoma revealed by blunt abdominal trauma which we recognized accidentally after trauma. Detail evaluation were performed on this patient according to history, previous imaging studies which lead to possible early diagnosis.

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Section: Discussionmentioning

confidence: 99%

“…Splenic infarction or splenic rupture are exceedingly unusual presentation of PDAC [1][2][3][4][5]. In pancreas head cancer, painless jaundice, upper abdominal pain may be clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

Very Unusual Presentation of Pancreatic Cancer Revealed by Traumatic Spleen Injury

Paik¹

2012

JCT

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“…2 Splenic rupture is a rare sign of pancreatic malignancy, with only six cases previously reported. [3][4][5][6] The present case represents the fi rst report of pancreatic adenosquamous carcinoma presenting as a splenic rupture. Atraumatic splenic rupture is very rare and is associated with a variety of conditions.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic adenosquamous carcinoma presenting as splenic rupture: Report of a case

et al. 2011

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A 58-year-old female patient presented with the sudden onset of left upper quadrant pain. The physical examination revealed the presence of shock status. Abdominal computed tomography revealed splenomegaly with a huge mass inside the spleen, and massive fluid collection in the abdominal cavity. After splenic artery embolization, laparotomy was performed. The operative findings revealed intra-abdominal hemorrhage and rupture of the lower pole of the spleen. Furthermore, a palpable solid mass was observed at the splenic hilum, and distal pancreatectomy with splenectomy was performed. The macroscopic findings revealed a pancreatic tail tumor at the splenic hilum directly invading the splenic parenchyma. Microscopic examinations showed the tumor to consist of squamous cell carcinoma. Furthermore, old and new thrombi were observed inside small splenic arteries. These findings were considered to represent invasion of pancreatic adenosquamous carcinoma to the spleen, and rupture of the spleen was attributed to splenic ischemia resulting from cancer invasion and splenic vein obstruction.

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“…Spontaneous splenic rupture (SSR) due to metastatic deposit rupture is a rare condition. Among such cases, the primary tumor site being the pancreas is even rarer [1][2][3]. It is seldom considered in the differential diagnosis of the acute abdomen, especially in the absence of a previous diagnosis of cancer.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Splenic Rupture due to Metastatic Pancreatic Cancer

Politis

Myoteri

Bourou

et al. 2021

Case Reports in Surgery

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Introduction. Nontraumatic splenic rupture is a rare event. On the other hand, splenic metastasis is also rare and usually found in the context of disseminated disease. Spontaneous splenic rupture caused by a metastatic deposit has been reported only as case reports. To the best of our knowledge, pancreatic cancer being the primary site has been reported in only a handful of cases. Case Presentation. A case of spontaneous splenic rupture in a 68-year-old male presenting with acute onset left shoulder pain, caused by metastatic pancreatic cancer to the spleen, is presented herein. During the investigation, the patient developed hypovolemic shock due to intra-abdominal hemorrhage, necessitating emergency splenectomy. The patient recovered well and was discharged from the hospital on the 8th postoperative day. Discussion. This study underlines the fact that the spleen is a rare site of metastasis, remaining mostly asymptomatic. However, it can nevertheless prove to be a life-threatening condition. The exact pathophysiological mechanism of splenic rupture due to metastasis still remains unknown, requiring further research. Emergency splenectomy remains the standard of care, and this clinical condition should be considered in the differential diagnosis of cases with acute abdomen and malignant neoplasm history.

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Unusual Presentation of Pancreatic Mucinous Cystadenocarcinoma by Spontaneous Splenic Rupture

Cited by 12 publications

References 12 publications

Very Unusual Presentation of Pancreatic Cancer Revealed by Traumatic Spleen Injury

Very Unusual Presentation of Pancreatic Cancer Revealed by Traumatic Spleen Injury

Pancreatic adenosquamous carcinoma presenting as splenic rupture: Report of a case

Spontaneous Splenic Rupture due to Metastatic Pancreatic Cancer

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