RESECTED SOLITARY SPLENIC METASTASIS 2 YEARS AFTER EARLY COLONIC CARCINOMA IN ONE ADULT

Abstract

We report a resected case of solitary splenic metastasis after polypectomy of early sigmoid colon cancer two years before.
The patient was an 82-year-old woman. She had under gone an endoscopic polypectomy for a sigmoid lp typed polypoid lesion at another hospital in October 1994. Histologically, Diagnosis was moderately differentiated adenocarcinoma invading the submnucosa (sm 2, ly 1, v 1, ce [-]). An additional resection was recommended, but she refused and had been followed-up carefilly. She was seen at our hospital because of urological symptoms in October 1996. An abdominal ultrasonography and a computed tomography showed a 3cm tumor of the spleen. The serum lactase dehydrogenase (LDH) level was slightly elevated, Ga scintigraphy revealed a slight accumulation in the spleen and no abnormality in any other organ. A preoperative diagnosis of primary tumor of the spleen was made and laparoscopic splenectomy was performed.
Histopathological findings of the resected splenic tumor detected the same histological type as the early sigmoid polypoid carcinpma. Therefore, a diognosis was determined of metastasis of the early sigmoid colon carcinoma to the spleen without any other distant metastases. This case was unique in that the tumor of early stage colon cancer resulted in splenic metastasis in two years.