A Case of Metachronous Solitary Splenic Metastasis of Gastric Cancer

Abstract

A 76-year-old woman presented to our hospital with anemia. Further investigation showed Type 3 gastric cancer of the lesser curvature of the antrum, and open distal gastrectomy was performed. The staging was T4a (SE) N1 M0 pStage IIIA, and since the patient did not wish to undergo postoperative chemotherapy, she merely underwent regular follow-up examinations. In postoperative Year 2, tumor markers were elevated, and positron emission tomography-computed tomography showed a solitary site of uptake in the spleen. However, the patient did not wish active treatment. In postoperative Year 3, the tumor in the spleen had grown in size, and since the patient requested surgical treatment, open splenectomy and diaphragmectomy were performed. Histopathological testing showed that the tumor was a metastasis of gastric cancer. Today, 3 years after the second operation, the patient remains recurrence-free. Splenic metastasis of gastric cancer is regarded as one form of distant metastasis, but cases of long-term survival after the resection of metachronous solitary splenic metastasis have been reported, and proactive resection should be performed.