Splenectomy to treat splenic lesions: An analysis of 148 cases at a cancer center

Abstract

While the spleen is an uncommon site of metastatic disease, in patients with a history of cancer, splenic masses selected for resection are frequently malignant.

Non-occlusive Mesenteric Ischemia after Splenic Metastasectomy for Small-Cell Lung Cancer

“…The lesion in the present case may have been infectious, such as an abscess or other malignancy, as it did not respond to chemotherapy compared with the intrathoracic lesions. Splenectomy is relatively safe compared with FNAB and should be performed for both diagnosis and treatment (13). We therefore decided to perform splenectomy in this case.…”

An unusual site of metastasis: splenic metastastasis from a colon cancer

“…Metastasis to spleen from non-hematological diseases are very uncommon, old autopsy series reported prevalence between 0%  and 34%, but according to more recent series, the prevalence ranges between 3% and 7% [1–5]. The main sites of primary tumors that metastasize to spleen are lung, colon and rectum, ovary, malignant melanoma or breast [3, 5].…”

“…Splenic secondary tumors are very rare, few datas are available in the literature regarding their clinical and biological behavior [1]. The main primary sites of these tumors are breast, lung, skin, ovary or colon/rectum [2, 3].…”

“…The main primary sites of these tumors are breast, lung, skin, ovary or colon/rectum [2, 3]. Metastasis from colon are very uncommon, and the left colon is usually the source of these tumors [1–3]. Despite its rich vasculature, the spleen is very rarely involved by metastasis.…”

Melanom in izolirane metastaze v vranici-prikaz primera in pregled literature

“…Kljub temu, da nekateri avtorji omenjajo možnost biopsije izoliranih vraničnih sprememb s tanko igelno aspiracijsko biopsijo, je ta metoda tvegana, predvsem zaradi možnosti krvavitve, zato se praktično ne uporablja.12 V objavljeni seriji splenektomij pri bolnikih z anamnezo malignoma zaradi suma na metastaze v vranici, postavljenega s slikovnimi preiskavami, se je pokazalo, da ena tretjina takih bolnikov nima metastaz, pač pa benigne spremembe, najpogosteje hemangiome. 6 Metastatska prizadetost vranice je redka in se pojavlja predvsem v končnem stadiju maligne bolezni, ko je prisotna večorganska metastatska prizadetost organizma.1,12 Pred letom 1990 so poročila o številu rakavih bolezni, ki so sekundarno prizadela vranico, izhajala iz obdukcijskih zapisnikov.3,4 Po letu 1990 pa se število opisanih primerov metastatske infiltracije vranice pri bolnikih z napredovalimi rakavimi boleznimi solidnih organov povečuje predvsem zaradi razvijajočih se tehnik slikovne diagnostike (UZ, CT).12,13 V zadnjih letih je v literaturi tudi vse več opisanih primerov izoliranih metastaz v vranici, odkritih zaradi vse večje uporabe FDG-PET/CT pri sledenju bolnikov z rakavo boleznijo.13 V nasprotju s konvencionalnimi slikovnimi metodami, ki ne morejo z gotovostjo ločiti med benigno in maligno Metastatska prizadetost vranice se največkrat odkrije šele pri obdukciji in naj bi bila prisotna pri 32-88 % bolnikov, ki so umrli zaradi melanoma.14 V življenju so metastaze največkrat asimptomatske in se zato najdejo naključno v sklopu rednega sledenja z različnimi slikovnimi preiskavami.12 Izolirana metastatska prizadetost vranice v sklopu melanoma je bila do sedaj v literaturi redko opisana (Tabela 1). Njeno redkost lahko ponazorimo s študijo de Wilta z ene največjih klinik za melanom, Sydney Melanoma Unit, ki je pregledal popise 10 000 bolnikov z melanomom, ki so se zdravili med letoma 1990 in 2001 ter samo pri šestih ugotovil izolirano metastatsko bolezen v vranici.…”