A case of metachronous solitary splenic metastasis from cancer of the ascending colon managed by laparoscopic surgery

Abstract

A case of metachronous solitary splenic metastasis from cancer of the ascending colon is reported. The patient was a 72-year-old woman undergone right hemicolectomy for cancer of the ascending colon in February 2007. The patient's postoperative course had been uneventful until 13 months after the surgery, when serum CEA level elevated to 5.5ng/ml and splenic metastasis was revealed by CT scan, MRI and FDG-PET examination ; no other distant metastases were seen. Metachronous salitary splenic metastasis of cancer of the ascending colon was diagnosed and splenectomy was performed by laparoscopic operation in March 2008. The operating time was 157 minites and the intra operative blood loss was 87 ml. Histological findings showed moderately differentiated adenocarcinoma compatible with that of the primary tumor. The postoperative course was uneventful and serum CEA level was normalized. There have been no signs of recurrence 6 months after the operation. Splenic metastasis of malignant tumors is relatively rare and the metastasis of colon cancer is extremely rare. So far only 34 cases including ours have been reported in Japan. There are some patients with solitary splenic metastasis from colon carcinoma who survive for a long time, and thus radical surgery would be recommended for such patients.