Chirurgie bei primären Milztumoren und Metastasen der Milz

Huettl, F.; Lang, H.

doi:10.1007/s00104-023-01978-8

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…Thus, a new lesion in the spleen in the imaging follow-up of a patient who underwent resection for CRC may pose some challenging problems of diagnosis and treatment. An accurate imaging differentiation of benign/malignant spleen lesions is critical for the proper management, particularly in the context of a patient with previous malignancies; commonly, an SM is hypoechoic on ultrasonography, hypodense on contrast-enhanced CT in the venous phase, hypointense on T1-weighted MRI sequences images following contrast administration, and intense hypermetabolic on PET-CT [58,[92][93][94][95][96]. It is worth mentioning the case of a patient diagnosed with concurrent rectosigmoid carcinoma and primary splenic malignant lymphoma mimicking an SM of CRC origin [97].…”

Section: Discussionmentioning

confidence: 99%

A Glimpse into the Role and Effectiveness of Splenectomy for Isolated Metachronous Spleen Metastasis of Colorectal Cancer Origin: Long-Term Survivals Can Be Achieved

Tivadar,

Dumitrascu,

Vasilescu

2024

JCM

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Background: Many papers exploring the role of resectioning metastases in colorectal cancer (CRC) have focused mainly on liver and lung sites, showing improved survival compared with non-resectional therapies. However, data about exceptional metastatic sites such as splenic metastases (SMs) are scarce. This paper aims to assess the role and effectiveness of splenectomy in the case of isolated metachronous SM of CRC origin. Methods: The patients’ data were extracted after a comprehensive literature search through public databases for articles reporting patients with splenectomies for isolated metachronous SM of CRC origin. Potential predictors of survival were explored, along with demographic, diagnostic, pathology, and treatment data for each patient. Results: A total of 83 patients with splenectomies for isolated metachronous SM of CRC origin were identified. The primary CRC was at an advanced stage (Duke’s C—70.3%) and on the left colon (45.5%) for most patients, while the median interval between CRC resection and SM was 24 months. The median overall survival after splenectomy was 84 months, and patients younger than 62 years presented statistically significantly worse overall survival rates than those ≥62 years old (p = 0.011). There was no significant impact on the long-term outcomes for factors including primary tumor location or adjuvant chemotherapy (p values ≥ 0.070, ns). Laparoscopic splenectomy was increasingly used in the last 20 years from 2002 (33.3% vs. 0%, p < 0.001). Conclusions: Splenectomy is the optimal treatment for patients with isolated metachronous SM of CRC, with the laparoscopic approach being increasingly used and having the potential to become a standard of care. Encouraging long-term survival rates were reported in the context of a multidisciplinary approach. Younger ages are associated with worse survival. Perioperative chemotherapy in the context of a patient diagnosed with SM of CRC origin appears to be a reasonable option, although the present study failed to show any significant impact on long-term survival.

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Section: Discussionmentioning

confidence: 99%

A Glimpse into the Role and Effectiveness of Splenectomy for Isolated Metachronous Spleen Metastasis of Colorectal Cancer Origin: Long-Term Survivals Can Be Achieved

Tivadar,

Dumitrascu,

Vasilescu

2024

JCM

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Laparoscopic Subtotal Splenectomy: A Feasible Option in the Treatment of Splenic Metastasis

Izquierdo,

García-Picazo,

Rodríguez

et al. 2024

Ann Surg Oncol

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Introduction Laparoscopic subtotal splenectomy (LSS) is a procedure that helps avoid the consequences of asplenia. Given the spleen’s importance and functionality, there may be specific indications and patient conditions in which partial splenectomy is beneficial. This case report aims to clarify the indications for LSS and outline the surgical technique. Methods This multimedia article provides a comprehensive overview of the surgical procedure, emphasizing key steps to avoid postoperative bleeding and complications. Results The patient was hospitalized for 3 days without any complications observed. Postoperative hemoglobin levels were 11.2 g/dL, with no signs of anemia. The patient was discharged with a follow-up visit after 2 weeks, showing no evidence of postoperative complications. The anatomopathological study revealed a nodular area with extensive tumoral necrosis. Discussion LSS is a safe surgical option that might help to mitigate the consequences of total splenectomy. Innovative technology in hemostasis, such as COOLINGBIS© (a monopolar electrosurgical electrode designed for hemostatic sealing and coagulation) can help manage this risk. Identifying the vascular pedicle via computed tomography scan is crucial to prevent unexpected bleeding. Conclusions In selected cases, LSS is a feasible and safe procedure when performed with appropriate laparoscopic equipment and by experienced surgeons.

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Spontaneous splenic rupture as the initial symptom of splenic angiosarcoma: case report and literature review

Jiang,

Li,

Chen

et al. 2024

Front. Oncol.

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Spontaneous splenic rupture is an extremely rare occurrence, often attributed to tumorous pathologies. Among these, primary splenic angiosarcoma stands as a malignancy arising from the endothelial cells within the spleen. While sporadic cases have been reported globally, there remains a lack of comprehensive consensus on standardized approaches for diagnosis and treatment. We report a case of an 83-year-old male who underwent emergency enhanced CT due to sudden shock, revealing significant intra-abdominal fluid accumulation. Emergency surgery revealed splenic rupture necessitating splenectomy. Histopathological examination confirmed the diagnosis of splenic angiosarcoma. Despite successful surgery, the patient succumbed to severe complications two weeks postoperatively.

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Chirurgie bei primären Milztumoren und Metastasen der Milz

Cited by 3 publications

References 13 publications

A Glimpse into the Role and Effectiveness of Splenectomy for Isolated Metachronous Spleen Metastasis of Colorectal Cancer Origin: Long-Term Survivals Can Be Achieved

A Glimpse into the Role and Effectiveness of Splenectomy for Isolated Metachronous Spleen Metastasis of Colorectal Cancer Origin: Long-Term Survivals Can Be Achieved

Laparoscopic Subtotal Splenectomy: A Feasible Option in the Treatment of Splenic Metastasis

Spontaneous splenic rupture as the initial symptom of splenic angiosarcoma: case report and literature review

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