A Case of Metachronous Isolated Splenic Metastasis from Gastric Cancer

Abstract

We report a case of metachronous isolated splenic metastasis from gastric cancer in a 73-year-old man. The patient underwent total gastrectomy reconstructed with the Roux-en-Y method for a gastric cancer [U, Less, neuroendocrine carcinoma with adenocarcinoma, ypT3(SS), int, ly1, v2, pPM0, ypN1 ypStage IIB] with M, 0-IIa, tub1, ypt1a(M), ly0, v0, pDM0. Seven months later, abdominal ultrasonography showed a splenic tumor. Abdominal computed tomography (CT) and positron emission tomography (PET)/CT showed a hypodense mass in the spleen and focal ; an intense fluorine-18-fluorodeoxyglucose uptake with a standardized uptake value 16 (maximum) in the spleen was observed. The whole-body PET imaging showed no other lesions to suggest malignancy. Therefore, we conducted splenectomy under a diagnosis of solitary metastasis to the spleen from gastric cancer.

Histopathological examination showed moderately differentiated adenocarcinoma in the spleen, which was histologically compatible with the metastasis from gastric cancer. No evidence of recurrence has been found 27 months after surgery. We recommend splenectomy for metachronous isolated splenic metastasis from gastric cancer.