Isolated splenic metastasis of sigmoid colon cancer: a case report

Citation
T. Okuyama et al., Isolated splenic metastasis of sigmoid colon cancer: a case report, JPN J CLIN, 31(7), 2001, pp. 341-345
Citations number
32
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology
Journal title
JAPANESE JOURNAL OF CLINICAL ONCOLOGY
ISSN journal
0368-2811 → ACNP
Volume
31
Issue
7
Year of publication
2001
Pages
341 - 345
Database
ISI
SICI code
0368-2811(200107)31:7<341:ISMOSC>2.0.ZU;2-M
Abstract
We report the case of a 62-year-old man who developed isolated splenic meta stasis of sigmoid colon cancer. The patient underwent left hemicolectomy fo r Dukes C sigmoid colon cancer in February 1997. In March 1999, an abdomina l CT scan revealed a tumor 3 cm in size at the inferior pole of the spleen. The tumor was hyperechoic on ultrasonography. The serum carcinoembryonic a ntigen level was normal. Since no other site of recurrence was identified, a splenectomy was performed with a curative intent. At laparotomy, neither hepatic metastasis, peritoneal dissemination, lymph node metastasis nor loc al recurrence was detected. Histological findings of the splenic tumor were compatible with metastasis of the previously resected sigmoid colon adenoc arcinoma. The patient has been disease-free for 19 postoperative months. Im munohistochemical staining for urokinase-type plasminogen activator was pos itive in primary sigmoid colon cancer and splenic metastasis, but negative in lymph node metastasis; results that possibly reflect the difference in p rogenitor cells between splenic metastasis and lymph node metastasis or the difference in the microenvironment of cancer cells between the spleen and lymph nodes. Based on the present case, we recommend that clinicians pay cl ose attention to the spleen for the early diagnosis of isolated splenic met astasis when routinely evaluating abdominal CT scans and abdominal ultrason ography following curative resection of primary colorectal cancer.