Abstract
A case of rectal cancer metastasizing to only the spleen is reported. The patient was a 70-year-old man who had undergone subtotal gastrectomy with lymphnode dissection (R2) under a diagnosis of early gastric cancer in the department 8 years before. The patient has been followed up, and high serum levels of tumor markers were found. Barium enema showed a stenosis on the upper part of the rectum. Abdominal CT offered a suspicion of metastasis to the spleen. As endoscopic biopsy estimated the malignant tumor on the rectum, the low anterior resection and splenectomy were performed. The pathological specimen of the spleen showed the metastases of rectal carcinoma. After the resection of those lesions, the tumor markeres decreased to normal limit. This patient is doing well 1.5 years after surgery. A solitary metastasis to the spleen is considered very uncommon.
It is suggested that serum CEA well corellates with clinical course in the metastasis to the spleen. Relatively good prognosis can be expected for resectable cases having a metastasis to the spleen, and hence, such cases might be candidates for radical operation.
