Abstract
A case of cecum cancer metastasizing to the spleen ten months after a radical operation which was detected by elevated serum CEA is reported.
A 56-year-old woman developed a cecum carcinoma with high serum level of CEA. Although serum CEA level had been almost normalized after right hemicolectomy, it elevated again during the follow-up period. Splenic tumor suggestive of recurrent cecum cancer was pointed out by CT scan and angiogram. Splenectomy, sampling of lymph nodes, and resection of peritoneal nodules were performed at the 2nd operation. In histology, they were moderately differentiated adenocarcinoma consistent with the primary tumor. Tumor thrombus was observed in the splenic sinus.
Detection of splenic metastasis from colonic carcinoma is extremely rare during clinical course, since most splenic metastasis is found as a part of wide-spreaded metastasis in autopsy studies. Although prognosis of the patient with splenic metastasis is very poor, solitary metastasis will be indication for splenectomy. In this case hematogenous metastatic pattern was suggested.
