Isolated Splenic Metastases From Colon Cancer

Indudhara, Ramaiah; Vogt, David; Levin, H.; Church, Jarrod E

doi:10.1097/00007611-199706000-00010

Cited by 37 publications

(31 citation statements)

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“…The literature also reports that the left colon is the predominant site of tumoral lesion in patients with CRC and concomitant splenic metastasis, either synchronous (as in our clinical case) or metachronous 4,12 , which can be explained by the possible retrograde blood flow from the inferior mesenteric vein to the splenic vein, and from there, to the spleen 4,23 . In this clinical case, the pathological anatomy shows images of lymphatic and venous invasion, suggesting a dual method of neoplasm fixation, via hematogenous and lymphatic ways.…”

Section: Discussionsupporting

confidence: 61%

“…According to the literatura, the survival of patients submitted to splenectomy due to metachronous splenic metastases varies from 6 months to 7 years 4,11,12,24 , with average survival of 66.6 months 4,13 ; then, most authors defend the use of splenectomy in the presence of metachronous and isolated metastatic lesion in patients with primary colon cancer, followed or not by chemotherapy 4,9,11,12,14,17,20,23,24 . However, although the literature reports the use of splenectomy in synchronous isolated splenic metastases associated with CRC 4,12,25 , one of the described patients died of peritoneal carcinomatosis one year later and another patient developed secondary liver lesions after the splenectomy.…”

Section: Discussionmentioning

confidence: 99%

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Isolated splenic metastasis of colon cancer: a case report and literature review

Rosa

Martins

Lamelas

2012

J. Coloproctol. (Rio J.)

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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.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Isolated splenic metastasis of colon cancer: a case report and literature review

Rosa

Martins

Lamelas

2012

J. Coloproctol. (Rio J.)

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“…Only 26 cases of isolated solitary splenic metastasis from colorectal carcinoma have been reported in the English-language literature (Tables 1, 2) [4,5,9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Twenty-one cases were separately reported and five cases were described in two reports of patients with splenic metastases (one case in Lee et al [20] and four cases in Ishida et al [17]).…”

Section: Methods and Resultsmentioning

confidence: 99%

Isolated splenic metastasis from colorectal cancer

et al. 2011

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Splenic metastases are unusual, arising in less than 1% of all metastases. Isolated solitary splenic metastasis from colorectal carcinoma is considered exceptional. This rarity has been explained by several hypotheses relating to the anatomical, histological, and immunological features of the spleen. We review the reported cases of isolated solitary splenic metastasis from colorectal carcinoma and discuss the diagnostic and therapeutic options for this entity. We searched the English-language medical literature, using the Medline and Pubmed databases from January 1966 through July 2010, for articles reporting isolated splenic metastasis from colorectal carcinoma. Only 26 cases have been reported; four cases had synchronous splenic metastasis. Fifteen patients had regional lymph node involvement on diagnosis of primary carcinoma. The primary tumor was located in the left colon or in the rectum in 18 cases. Carcinoembryonic antigen (CEA) level was elevated in 73% of cases. All patients underwent curative splenectomy; only one patient had laparoscopic resection of the spleen. Mean reported survival interval was 19.5 months; only three patients were deceased at last follow-up. Solitary splenic metastasis from colorectal carcinoma is very rare; clinicians are advised to pay close attention when routinely evaluating patients with serial CEA levels and abdominal scans. Splenectomy seems to be the preferred treatment modality with improvement of long-term survival. However, definitive conclusions cannot be drawn from the small number of case reports available.

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“…For these reasons, the exact etiopathogenetic mechanism is uncertain but several hypotheses have been made. Idhuara [6] argues that the metastatic spread occurs probably because of blood reflux from the inferior mesenteric vein in the splenic vein and from there to the spleen. This is in relation to the fact that the localization of primary carcinoma in these patients is mostly at the level of the left hemicolon.…”

Section: R E V I S E D P R O O Fmentioning

confidence: 99%