2018 Volume 43 Issue 6 Pages 1096-1101
A 79-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer 4 years ago. Pathological findings were moderately differentiated tubular adenocarcinoma, T4 (SI, abdominal wall), N0, M0, Stage Ⅱ, and ly1, v2. He received internal administration of 8 courses of capecitabine after surgery. CEA levels gradually increased from 1 year and 3 months after surgery, so CT and FDG-PET were conducted 1.5 years after surgery, but no visible lesions were observed. 4 months later, CT showed multiple splenic tumors and a nodule in the area near the lower spleen; they were suspected of being multiple splenic metastases and peritoneal dissemination or accessory splenic metastases. Splenectomy and nodectomy were conducted. Pathological findings showed that the splenic tumors and nodules were sigmoid colon cancer metastases. Splenic tumors invaded the splenic capsule, so the nodule near the lower spleen was suspected as a disseminated lesion from the splenic tumors. Systemic chemotherapy was administered after surgery, but a new nodule was observed in the peritoneum in the area near the spleen 1 year after surgery. He was diagnosed with peritoneal recurrence. Chemotherapy was continued, and the disease condition was maintained under control.
As in this case, splenic metastatic lesions, which invade the splenic capsule and result in peritoneal dissemination, can appear and develop rapidly after colon cancer surgery, so we must pay attention to this.
