Isolated splenic metastasis from colon cancer: Case report

Abdou, Jiddou

doi:10.3748/wjg.v22.i18.4610

Cited by 15 publications

(32 citation statements)

References 28 publications

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“…According to Indudhara et al, it is the retrograde fl ow of blood through the inferior mesenteric vein and splenic vein that carries neoplastic cells to spleen [12]. Many authors are of the opinion that metachronous splenic metastasis is more CEA level (4.6-223 ng/mL) in colonic adenocarcinoma [13], as was also observed in our patient (184 ng/mL). CEA has been supposed to modulates the immune response and suppresses the humoral response as well as lymphocyte and NK cell activity [14].…”

Section: Discussionsupporting

confidence: 74%

Isolated splenic metastasis: An unusual presentation of colonic adenocarcinoma

Aijaz¹,

Hasan²,

Alam³

2019

Arch Clin Gastroenterol

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It is very uncommon situation in which primary colonic carcinoma is asymptomatic and presents as isolated splenic metastasis. Involvement of spleen by secondary tumors is usually seen in disseminated spread of tumor. However, isolated splenic involvement by tumor metastasis is an infrequent event, except in cases of lymphoid origin malignancy where spleen is commonly involved. We hereby report a case of 50 years old man who presented with gradually increasing pain abdomen for 3 months. USG report showed splenomegaly indicating either splenic abscess or hemangioma. Splenectomy was performed followed by pathological examination. Histopathological examination (HPE) revealed diffuse infi ltration of spleen by sheets and nests of malignant cells, suggesting metastatic adenocarcinoma to spleen. Subsequently computed tomography was done to fi nd out the site of primary tumor. Thus a cystic mass in left splenic fl exure of colon was identifi ed on CT scan. Biopsy was done that suggested colonic cancer. Hence a diagnosis of colonic mucinous adenocarcinoma with metastatic splenic involvement was made. Patient was operated for the same and managed accordingly. Based on this case, we concluded that surgeons should pay careful attention to splenic lesions as metastatic deposits can be there, especially in old aged patients having features that favor some ongoing malignant disease.

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Section: Discussionsupporting

confidence: 74%

Isolated splenic metastasis: An unusual presentation of colonic adenocarcinoma

Aijaz¹,

Hasan²,

Alam³

2019

Arch Clin Gastroenterol

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“…However, Abi saad et al [ 7 ] reported that splenectomy for isolated splenic metastasis can achieve long-term survival. Furthermore, Jiddou et al [ 8 ] reported 31 cases of isolated splenic metastasis from colorectal cancer, and splenectomy was performed in all cases. In addition, there are reports of laparoscopic approach too [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Jiddou et al [ 8 ] reported 31 cases of isolated splenic metastasis from colorectal cancer, and splenectomy was performed in all cases. In addition, there are reports of laparoscopic approach too [ 8 , 9 ]. Therefore, we performed laparoscopic splenectomy for the cure of isolated splenic metastasis, and yet histopathological examination of the spleen showed a sarcoid reaction.…”

Section: Discussionmentioning

confidence: 99%

Sarcoid reaction in the spleen after sigmoid colon cancer resection: a case report

et al. 2016

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BackgroundA sarcoid reaction is a phenomenon characterized by histologically proven granulomatous lesions without evidence of sarcoidosis. This pathology is a benign tumor itself, but several reports have described sarcoid reactions accompanying malignant tumors. Sarcoid reactions occur in various cancers, such as skin, lung, ovary, stomach, and breast cancers. However, only a few published reports have described sarcoid reactions in patients with colorectal cancer.Case presentationA 76-year-old woman underwent laparoscopic sigmoidectomy for sigmoid colon cancer. The postoperative follow-up computed tomography and 18-fluorodeoxyglucose positron emission tomography–computed tomography findings were suspicious for splenic metastasis of the sigmoid colon cancer. The patient then underwent laparoscopic splenectomy. Histopathological examination of the resected lymph nodes and spleen showed a non-caseating epithelioid cell granuloma. The patient was diagnosed with a sarcoid reaction.ConclusionsTo our knowledge, this is the first report of a sarcoid reaction in the spleen and regional lymph nodes after colon cancer resection. The effect of a sarcoid reaction on the prognosis in patients with colorectal cancer has not been fully determined because of the small number of such cases. Further analyses involving a larger number of cases are necessary to evaluate the relationship between sarcoid reactions and prognosis in patients with colorectal cancer. We herein present an extremely rare case of a sarcoid reaction in the spleen and regional lymph nodes.

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“…The most common metastatic organ of CRC is the liver, and it has been reported that almost 50% of patients diagnosed with CRC experienced simultaneous or heterogeneous liver metastases[ 3 , 7 ]. Splenic metastases in patients with malignant tumors generally indicate multiple metastases[ 1 , 2 ]. A splenic primary tumor or metastasis a rare disease, and the most common sources of splenic metastasis are melanoma (34%), breast cancer (12%), ovarian cancer (12%), CRC (10%), and lung cancer (9%)[ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Splenic metastases in patients with malignant tumors generally indicate multiple metastases[ 1 , 2 ]. Isolated splenic metastasis after radical colon adenocarcinoma resection is a rare clinical entity[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

Hu¹,

Zhu²,

Lei³

et al. 2020

WJCC

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BACKGROUND Isolated splenic metastasis is a rare clinical entity. Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated metachronous splenic metastasis are exceedingly rare. CASE SUMMARY We report a colon cancer patient who underwent laparoscopic radical colon resection 14 mo previously, and subsequently underwent a second local resection due to local recurrence detected by elevated serum carcinoembryonic antigen (CEA) and positron emission tomography (PET). However, multiple metastases in the spleen were found 7 mo later by elevated serum CEA and PET-magnetic resonance imaging. Then the patient underwent total laparoscopic splenectomy. Local tumor recurrence and splenic metastasis from colorectal cancer (CRC) were found by postoperative pathology. Genetic analysis of these recurrent and metastatic tissues showed KRAS exon2, APC exon16 and TP53 exon6 missense mutations, but no mutations of NRAS, KRAF, EGFR, ERBB2, MET, MLH1, MSH2 and MSH6 were detected. Chemotherapy and target therapy were administered after multiple disciplinary team (MDT) consultation, and no tumor recurrence has been observed to date. We also reviewed the literature by conducting a search of the PubMed database using the following key words: CRC, splenic metastasis, isolated, and review. We identified 34 relevant papers, which included 28 cases of metachronous metastasis and 6 cases of simultaneous metastasis. CONCLUSION Close monitoring of serum CEA levels is crucial for the detection of isolated splenic metastases after colon surgery. In terms of overall survival and progression-free survival, MDT plays an important role in the entire process of disease management.

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Isolated splenic metastasis from colon cancer: Case report

Cited by 15 publications

References 28 publications

Isolated splenic metastasis: An unusual presentation of colonic adenocarcinoma

Isolated splenic metastasis: An unusual presentation of colonic adenocarcinoma

Sarcoid reaction in the spleen after sigmoid colon cancer resection: a case report

Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

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