A Case of Metachronous Splenic Metastasis of Colon Cancer

Takehiro Noji, Tetsuyuki Okubo, Takashi Shimazaki, Satoshi Kondo^* and Hiroyuki Kato^*

Department of Surgery, Ebetsu City Hospital ^*Department of Surgical Oncology, Graduated School of Medicine, Hokkaido University

A review of the literature would suggest that cancer rarely metastasize to the spleen except in terminal states. We report a case of solitary splenic metastasis of colon cancer, the 23rd report of splenic metastasis of colon cancer in the Japanese literature.
A 68-year-old man was admitted our hospital in August 1999 because of a high blood CEA level (585.7ng/ml) and splenic tumor. He had a history of partial sigmoidectomy for residual sigmoid colon carcinoma in April 1997. (He had undergone endoscopic tumor resection at another hospital.) An abdominal CT scan revealed two low-attenuating masses, and angiography demonstrated two avascular tumors in the speen. A GI series and other examinations showed no significant changes in any other organs. It was difficult to determine whether the splenic tumor was metastatic carcinoma or other disease preoperatively, and surgery was performed in September 1999. No liver metastase or peritoneal carcinosis was found at laparotomy, and splenectomy was performed. The pathohistological diagnosis of the splenic tumor was metastatic adenocarcinoma of the colon. At 9 months after the operation, the blood CEA level had decreased to 2.3ng/ml, and there were no signs of recurrence. Radical surgery is recommended for colorectal carcinoma patients who have a multiple splenic metastasis.

Key words
Splenic metastasis, colon cancer, splenectomy

Reprint requests
Takehiro Noji Department of Surgery, Ebetsu City Hospital 6 Wakakusa-chyo, Ebetsu City, 067-8585 JAPAN

Accepted
November 29, 2000

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