Laparoscopic Approach for Isolated Splenic Metastasis

Abstract

The laparoscopic approach for splenic metastasis is feasible. Of course, it must be individualized in each case.

Solitary Splenic Metastasis from a Mucinous Adenocarcinoma of the Cecum. A Case Report

“…In addition, rhythmic contractions of the spleen force the blood flow from the sinusoids to the splenic veins, which, in cases of constant blood flow, could prevent tumor fixation [3]. Furthermore, it is hypothesized that the spleen produces an angiogenesis factor (angistatine) making it immune to metastasis compared with other organs [8], although other authors argue that neoplastic cells can reach the splenic vein and thus the splenic parenchyma through the inferior mesenteric vein. Moreover, the absence of afferent lymphatic vessels of the spleen, the phagocytic activity of the spleen cells, the inhibition exerted by the reticuloendothelial system (the spleen being the second largest organ of the system), or rhythmic contractions of this body all contribute to a low possibility of metastases in the spleen [6].…”

“…Metachronous disease is far the most common picture (as in our case) and the one in which laparoscopic splenectomy may have the most to offer in terms of survival along with the potential benefits of minimal access surgery. Lastly, carcinomatosis may suggest a role for splenic resection as a Brescue procedure^only after a patient has shown a good response to chemotherapy [8].…”

“…The reported incidence of splenic secondaries caused by colorectal neoplasia is approximately 4.4 %, with only 18 reported cases so far [1][2][3][4][5][6][7][8]. Most cases are asymptomatic and are usually diagnosed as incidentalomas in subsequent monitoring after a raised carcinoembryonic antigen (CEA) level [2,3].…”

Splenectomy indications and postoperative follow-up results of a department of general surgery

“…Splenic abscess, splenic infarction, thalassemia, idiopathic thrombocytopenic purpura, agnogenic myeloid metaplasia, sarcoidosis, amyloidosis, Gaucher's and Niemann-Pick diseases, Felty syndrome are some of the splenectomy indications (13,(15)(16)(17)(18)(19)(20). In addition to these, malign diseases of the spleen, invasion of malignant diseases and traumatic injuries are other indications (21)(22)(23).…”

“…The most common splenectomy indications are splenic injuries due to iatrogenic or external trauma nowadays (21,22,(24)(25)(26). The most common indication for elective splenectomy is ITP (26).…”