Abstract
We report a case of an 87-year-old man who developed an isolated splenic metastasis from rectal cancer.
The patient underwent low anterior resection for rectal cancer. Preoperative abdominal computed tomography (CT) showed a low density area measuring 9 × 6 mm in the spleen, but we could not confirm the diagnosis of the mass intraoperatively because of the upper abdominal firm adhesion caused by previous surgery. Histological findings of the rectal specimen showed moderately differentiated adenocarcinoma, Stage III a (SE, ly2, v2, N1). Four months after the surgery, abdominal CT showed that the tumor grew up to 38 mm in diameter, and fluorodeoxyglucose (FDG) positron emission tomography (PET) revealed abnormal uptake of FDG by the splenic tumor. No other metastatic lesion was found on either CT or FDG-PET. Based on these findings, we diagnosed an isolated splenic metastasis from rectal cancer, and splenectomy was performed. Histological diagnosis of the resected specimen confirmed a splenic metastasis from rectal cancer. The patient had an uneventful recovery, and he was alive without recurrence 8 months after the splenectomy.
Isolated splenic metastasis from colorectal cancer is rare ; we review and discuss the Japanese literature on this rare disease.
