Published in:
01-03-2019 | Case Report
Isolated Metachronous Splenic Metastasis from Colon Cancer: Possible Explanations for This Rare Entity
Published in: Journal of Gastrointestinal Cancer | Issue 1/2019
Login to get accessExcerpt
The incidence of splenic metastases secondary to colorectal cancer is very low; these lesions have been more frequently reported as secondary to breast, lung, and ovarian cancer. Splenic metastases are particularly common in melanoma; their incidence has been reported as being as high as 34% at autopsy [1]. Most cases of secondary splenic metastases have been described in patients with tumors of the left colon while only few cases being reported as originating from right colon tumors (Table 1). The finding of a splenic mass in the absence of a history of malignancy suggests a primary lesion (lymphoma, hematoma, etc.), while a history of oncological disease raises the possibility of a secondary lesion [2].
Table 1
Literature review of isolated metachronous splenic metastasis from colorectal carcinoma
|
Case n
|
Year
|
Pathology
|
Primary tumor
|
Stage
|
Intervala
|
CEA level
|
|---|---|---|---|---|---|---|
|
1
|
1969
|
Adeno
|
Rectum
|
III
|
48
|
Not specified
|
|
2
|
1982
|
Adeno
|
Sigmoid
|
III
|
48
|
A
|
|
3
|
1986
|
Adeno
|
Cecum
|
III
|
30
|
A
|
|
4
|
1992
|
Adeno
|
Rectum
|
II
|
60
|
A
|
|
5
|
1993
|
Adeno
|
Left colon
|
II
|
144
|
A
|
|
6
|
1997
|
Adeno
|
Splenic flexure
|
III
|
42
|
A
|
|
7
|
1997
|
Adeno
|
Sigmoid
|
II
|
24
|
A
|
|
8
|
1999
|
Adeno
|
Rectum
|
Not specified
|
12
|
|
|
9
|
1999
|
Adeno
|
Sigmoid
|
III
|
3
|
A
|
|
10
|
1999
|
Left colon
|
||||
|
11
|
2000
|
Adeno
|
Right colon
|
III
|
36
|
A
|
|
12
|
2000
|
Adeno
|
Not specified
|
Not specified
|
108
|
A
|
|
13
|
2001
|
Adeno
|
Sigmoid
|
III
|
72
|
A
|
|
14
|
2001
|
Adeno
|
Left colon
|
IV
|
52
|
A
|
|
15
|
2001
|
Left colon
|
||||
|
16
|
2001
|
Adeno
|
Sigmoid
|
III
|
23
|
A
|
|
17
|
2003
|
Adeno
|
Left colon
|
72
|
||
|
18
|
2004
|
Adeno
|
Sigmoid
|
III
|
21
|
N
|
|
19
|
2004
|
Adeno
|
Left colon
|
|||
|
20
|
2006
|
Adeno
|
Sigmoid colon
|
|||
|
21
|
2006
|
Adeno
|
Descending
|
III
|
17
|
A
|
|
22
|
2008
|
Adeno
|
Splenic flexure
|
IV
|
36
|
A
|
|
23
|
2008
|
Adeno
|
Traverse colon
|
III
|
9
|
A
|
|
24
|
2008
|
Adeno
|
Rectum
|
III
|
18
|
A
|
|
25
|
2008
|
Adeno
|
Sigmoid
|
II
|
24
|
A
|
|
26
|
2009
|
Adeno
|
Hepatic flexure
|
III
|
60
|
A
|
|
27
|
2010
|
Adeno
|
Splenic flexure
|
III
|
24
|
A
|
|
28
|
2010
|
Adeno
|
Ascending
|
III
|
15
|
A
|
|
29
|
2011
|
Adeno
|
Rectum
|
III
|
15
|
N
|
|
30
|
2015
|
Adeno
|
Cecum
|
I
|
16
|
A
|
|
31
|
2016
|
Adeno
|
Descending
|
III
|
28
|
N
|