Metastasis esplénica de un adenocarcinoma de colon derecho / Splenic metastasis of a right colon adenocarcinoma

Introducción: Las metástasis únicas en bazo de origen colorrectal son extremadamente infrecuentes. Sin embargo, debido el control postoperatorio más estricto de la patología oncológica con estudios por imágenes modernos, la incidencia ha ido aumentando en los últimos años. Objetivo: Exponer el caso de una paciente con una metástasis esplénica de un tumor colónico primario. Caso clínico: Paciente de sexo femenino, de 85 años con antecedentes de colectomía derecha laparoscópica. La anatomía patológica informó: adenocarcinoma de colon T2 N0, sin requerir tratamiento quimioterápico adyuvante. En el seguimiento postoperatorio, durante el segundo año intercurrió con aumento del antígeno carcinoembrionario (CEA). Se realizó PET-TC que evidenció nódulo hipercaptante único de 3 cm. en bazo. Se programó la esplenectomía laparoscópica, evolucionando satisfactoriamente. La anatomía patológica definitiva informó adenocarcinoma metastásico de origen colónico. Conclusión: La metástasis esplénica de un tumor colónico es extremadamente infrecuente, existiendo solamente casos aislados en la literatura. En pacientes sin otro compromiso sistémico la esplenectomía debe recomendarse. (AU)

Introduction: Isolated splenic metastases are highly uncommon. The incidence has been increasing during the last years due to better medical imaging and long term follow up. Objective: We report a case of a patient who developed isolated splenic metastasis from right colon cancer. Case presentation: Female, 85 years old who underwent a laparoscopic right colectomy. The pathologic investigation confirmed: colon adenocarcinoma staged as T2 N0, without need of oncologic adjuvant therapy. In the postoperative follow up, during the second year, an increased serum carcinoembryonic antigen level was noticed. A PET TC was carried out and demonstrated a 3 cm focus of high radiotracer uptake in the spleen. Laparoscopic splenectomy was performed, postoperative course was uneventful. Pathologic exam demonstrated splenic parenquima invaded with adenocarcinoma originated in colon. Conclusion: Isolated splenic metastases is a very rare clinical entity. Only few case reports can be found in the literature. If they are no other sites of disease, splenectomy should be the optimal approach.

Isolated splenic metastasis from colon cancer: Case report.

Isolated splenic metastases from colorectal cancer are very rare clinical entities and when they are present, they usually manifest widely disseminated disease. In this paper we report a case of metachronous solitary isolated splenic metastasis from colon cancer in a 64-year-old woman who was successfully treated by laparoscopic splenectomy. We discuss the pathological and clinical aspects of this condition. We furthermore comment on the diagnostic and therapeutic options of this rare entity through our observation of the case and consideration of the 31 case reports published in the literature.

Isolated Splenic Metastases of Her2+++ Gastroesophageal Junction Adenocarcinoma.

Isolated metastases from gastric adenocarcinoma to the spleen are very infrequent. Usually, there are multiple metastases from gastric cancer, and isolated splenic metastases are very rare [Lam and Tang: Arch Pathol Lab Med 2000;124:526-530] because of certain anatomical and physiological characteristics (e.g., angulation between the splenic artery and celiac trunk, paucity of afferent lymph flow toward the spleen, contractility of the spleen and major immune content). Here, we report 2 cases of isolated splenic metastases from an adenocarcinoma of the gastroesophageal junction, both with long-term survival outcome and overexpression of Her2.