A Case of Solitary Splenic Metastasis of Colon Cancer 10 Years after the Right Hemicolectomy

Tomohiro Yamaguchi¹⁾³⁾, Tetsuro Yamashita¹⁾, Kazuma Koide¹⁾, Fumihiro Taniguchi¹⁾, Yasuhiro Shioaki¹⁾, Takashi Hamashima¹⁾, Eito Ikeda¹⁾, Fumitaka Mutoh¹⁾, Hideaki Kurioka¹⁾ and Youhei Hosokawa²⁾

Departments of Surgery¹⁾ and Department of Pathology²⁾, Kyoto First Red Cross Hospital Department of Surgery, Shiga University of Medical Science³⁾

A 76-year-old man developing solitary splenic metastasis in ascending colon cancer underwent right hemicolectomy in April 1993. In October 2003, serum carcinoembryonic antigen was extremely high and ultrasonography showed a 10 cm tumor in the spleen. Abdominal CT showed a low-density mass invading the left kidney and diaphragm, accompanied by lymph node swelling at the posterior left renal vein, necessitating splenectomy with extraction of the left kidney, left adrenal gland, and part of the diaphragm in January 2004. Macroscopically, the tumor was partly grayish white with massive necrosis and had invaded the left kidney, diaphragm, and left adrenal gland. Microscopically, the splenic tumor was diagnosed to be well-to moderately-differentiated adenocarcinoma consistent with the primary colonic tumor resected elsewhere 10 years previously. We diagnosed it as solitary splenic metastasis of ascending colon cancer with invasion to adjacent organs. Based upon the present case, a splenic mass detected by ultrasonography and/or CT in a patient with high serum CEA should be considered for metastasis during follow-up after curative resection in primary colorectal cancer.

Key words
colon cancer, splenic metastasis, CEA

Reprint requests
Tomohiro Yamaguchi Department of Surgery, National Cancer Center
5-1-1 Tsukiji, Chuo-ku, 104-0045 JAPAN

Accepted
April 27, 2005

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