Rosa N, Martins S, Lamelas J. Isolated splenic metastasis of colon cancer: a case report and literature review. J Coloproctol, 2012;32(1): 89-94. AbstRACt:Colorectal cancer (CRC) is a leading cause of death in the elderly and about 20% of these patients present metastasis at diagnosis, most often in the liver. Other common metastatic sites include: lung, bone and brain. Isolated splenic metastases are rare, and they are usually a sign of widespread disease. The authors report a case of the rare occurrence of synchronous isolated splenic metastasis, diagnosed by computed tomography in the preoperative staging of a patient with CRC.Keywords: colorectal cancer; metastatic disease; splenic metastasis.Resumo: O câncer colorretal (CCR) é uma das principais causas de morte na população geriátrica, aproximadamente, 20% desses pacientes já apresentam, na altura do diagnóstico, metástase neoplásica, mais frequentemente hepática. Outros locais comuns de metastização incluem: pulmão, ossos e cérebro. As metástases esplênicas isoladas de CCR são raras, sendo habitualmente sinal de doença generalizada. Os autores relatam um caso clínico da ocorrência rara de metástases esplênicas isoladas síncronas, diagnosticadas através da tomografia computadorizada durante o estadiamento pré-operatório de um doente com CCR.Palavras-chave: câncer colorretal; metástase neoplásica; metástases esplênicas.

Background: Globally, it is estimated there will be a 43% increase in breast cancer-related deaths from 2015 to 2030, largely as a result of cancer metastasis. Metastatic breast cancer (mBC) is the most advanced stage of breast cancer where the cancer has spread from the original site to other parts of the body. While resources are available for early detection of breast cancer, there is a lack of information and support for those with an advanced breast cancer diagnosis in Brazil. To address this need, Instituto Oncoguia developed the National Metastatic Breast Cancer Patient Support Network, the “More Life Network.” This research is part of the Network initiative and seeks to increase knowledge and support for patients living with mBC. Aim: The aim of this study is to examine the mBC patient journey through diagnosis, treatment and quality of life after diagnosis. Methods: In May 2018, we conducted a cross-sectional study of mBC patients in Brazil. Patients were recruited voluntarily through online platforms. A quantitative online survey instrument was used for data collection. Frequency analysis was conducted across the main subject areas: knowledge, diagnosis, treatment, and quality of life. Results: A total of 188 online surveys were included in the analysis. Participants represent 20 of 26 states in Brazil and have a mean age of 44. Of the 188 participants, 114 are members of the Network. Knowledge about mBC was assessed through patient self-reporting. Approximately one third of patients (32%) reported little to no knowledge of mBC. When a patient does have questions about their diagnosis and treatment, a majority (83%) seek information from their physician. The Network was also indicated as a resource referenced by patients (51%). To understand the cancer journey, questions focused on diagnosis, treatment, and quality of life. Twenty-two percent (22%) of patients stated the most complicated or longest step of their journey was identifying symptoms of metastasis. The process of diagnosis was challenging, as well. Thirty-six percent (36%) of patients reported their metastasis was an incidental (by chance) diagnosis and 30% had little or insufficient information about the possibility of metastasis. After diagnosis, only 17% of patients continued working, while 78% worked prior to diagnosis. During treatment, the greatest hurdles in the patient journey include a decline in quality of life (42%) and lack of understanding or access to information about mBC (31%). The life of the patient is also impacted after diagnosis and treatment. Sixty-eight percent (68%) of patients expressed fear of the future and 61% felt they could no longer do the activities they previously enjoyed. Conclusion: This research demonstrates the lack of available information specific to a mBC diagnosis and the need for additional support throughout the cancer journey for patients living with mBC. Current breast cancer resources do not adequately address these challenges.