Abstract
Splenic metastasis of gastric cancer occurs in a frequency from 3 to 10% of all autopsy cases, but rarely diagnosed preoperatively with a successful resection. This paper describes such a resected case of a cancer of the residual stomach metastasizing to the spleen.
A 49-year-old man was admitted to the hospital because of the fullness of abdomen and edema of lower extremities, who had been attending the department of internal medicine for anemia since about 3 years before. There was a history of undergoing distal gastrectomy for gastric cancer 30 years before. On admission, cancer of the residual stomach metastasizing to the spleen was diagnosed via various imaging methods, and total gastrectomy with resection of the body and tail of pancreas, spleen, and a part of the jejumum was performed. Macroscopic findings included P0H0N3S2 Stage IV, 8×8cm in size, circ, and Borrmann type 3 gastric cancer. Histological diagnosis was moderately differentiated adenocarcinoma of the residual stomach with findings of INFβ, se, ly2, v3, n3 (+). The spleen was 16×7.5cm in size and had a tumor (11×8.5cm) in subcapsular. It was thought that this splenic tumor might be hematogenously metastasized from the cancer of the residual stomach, because histological findings showed severe tumor embolius in the splenic vein.
