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Andryukhova ES, Tashireva LA, Isaeva AV, Vtorushin SV, Zavyalova MV, Perelmuter VM. The Rarity of Metastasis to the Spleen — a Phenomenon with an Unknown Mechanism. Bull Exp Biol Med 2022; 173:575-582. [DOI: 10.1007/s10517-022-05591-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Indexed: 11/05/2022]
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Isolated Splenic Metastasis of Primary Lung Cancer Presented as Metachronous Oligometastatic Disease—A Case Report. Diagnostics (Basel) 2022; 12:diagnostics12010209. [PMID: 35054377 PMCID: PMC8775270 DOI: 10.3390/diagnostics12010209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
Modern oncology practice and new antitumor drugs prolonged disease-free intervals in patients with lung cancer. Patients with distant metastatic disease are treated only with palliative intent. The International Association for the Study of Lung Cancer, in the 8th edition of the TNM classification, for the first time includes oligometastatic disease as a clinical state that describes the patients with distant metastasis, limited in number and organ sites, who may have more indolent biology. In this paper, we present a case of a 56-year-old man who was admitted to our clinic regarding a radiologically diagnosed splenic lesion of uncertain nature, and who underwent a left upper lobectomy for primary lung cancer 12 years before. After a detailed radiological diagnosis, it was concluded that it is highly suspected metastatic lesion of the spleen and the patient underwent a splenectomy. While no definitive protocols exist on the management of isolated splenic metastasis from lung cancer, splenectomy, in suitable patients, with reasonable survival expectations, improves patient disease-free survival and can prevent potentially life-threatening complications, such as splenic rupture. 18F-FDG PET has very high sensitivity and specificity for differentiating benign and malignant splenic lesions especially in patients who are in the follow up protocol due to primary malignancy.
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Matsuoka K, Yamada T, Matsuoka T, Nagai S, Ueda M, Miyamoto Y. Solitary Splenic Metastasis of Lung Cancer Presenting as Benign Cystic Disease. Ann Thorac Cardiovasc Surg 2019; 27:403-406. [PMID: 31554769 PMCID: PMC8684837 DOI: 10.5761/atcs.cr.19-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Solitary splenic metastasis from primary lung cancer is extremely rare. Here, we demonstrated a solitary splenic metastasis of primary lung cancer that was difficult to distinguish from benign cystic disease. A 69-year-old-female was diagnosed as middle lobe lung cancer. Although preoperative abdominal computed tomography (CT) demonstrated a low-density splenic nodule, fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed no fluorodeoxyglucose uptake in the splenic nodule. Therefore, the nodule was diagnosed as benign cystic disease and middle lobe lobectomy was performed. Postoperative pathologic examination demonstrated papillary-predominant adenocarcinoma with mucin, and the tumor was diagnosed as primary lung cancer. However, the splenic nodule continued to increase postoperatively. Splenectomy was undergone 30 months after the pulmonary resection and the splenic tumor was diagnosed as the splenic metastasis of lung cancer. In the 24 months since the splenectomy, no recurrence has been observed in the absence of treatment. Splenectomy was an effective treatment for solitary splenic metastasis of lung cancer in this case. FDG uptake in the splenic tumor was not evident due to marked mucus production.
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Affiliation(s)
- Katsunari Matsuoka
- Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan
| | - Tetsu Yamada
- Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan
| | - Takahisa Matsuoka
- Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan
| | - Shinjiro Nagai
- Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan
| | - Mitsuhiro Ueda
- Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan
| | - Yoshihiro Miyamoto
- Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan
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Nishikawa T, Takahashi M, Mori M, Kamikawa Y, Inoue F. Solitary splenic metastasis of pulmonary carcinoid: A rare case report and literature review. Mol Clin Oncol 2017; 7:163-166. [PMID: 28781779 PMCID: PMC5532704 DOI: 10.3892/mco.2017.1312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 05/10/2017] [Indexed: 11/15/2022] Open
Abstract
We herein report a rare case of solitary splenic metastasis of a pulmonary carcinoid, for which hand-assisted laparoscopic splenectomy was performed. A 73-year-old man was admitted to the Inoue Hospital (Fukuyama, Japan) in March 2015 with an abnormal shadow of the spleen. The patient had a history of right upper lobectomy with lymph node dissection for a pulmonary typical carcinoid (pT1N0M0 stage IA) 7 years earlier. Plain abdominal computed tomography (CT) revealed a low-density area in the spleen. Enhanced abdominal CT revealed a mass in the spleen measuring 3×3 cm. Blood tests and tumor marker analysis revealed no abnormalities. Abdominal magnetic resonance imaging revealed a mass that was low-intensity on T1- and high-intensity on T2-weighted images, and positron emission tomography revealed abnormal fluorodeoxyglucose accumulation in the mass. Hand-assisted laparoscopic splenectomy was performed for diagnosis and treatment. The resected specimen included a reddish-brown mass. On immunohistochemistry, the mass was positive for chromogranin A, synaptophysin and CD56, which was similar to the resected pulmonary carcinoid tumor; thus, splenic metastasis of pulmonary carcinoid was diagnosed. The postoperative course was uneventful and the patient is currently under observation and remains recurrence-free, with no adjuvant chemotherapy.
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Affiliation(s)
- Toshio Nishikawa
- Department of Thoracic Surgery, Inoue Hospital, Fukuyama, Hiroshima 721-0974, Japan
| | - Masahiko Takahashi
- Department of Thoracic Surgery, Inoue Hospital, Fukuyama, Hiroshima 721-0974, Japan
| | - Masanobu Mori
- Department of Thoracic Surgery, Inoue Hospital, Fukuyama, Hiroshima 721-0974, Japan
| | - Yasuaki Kamikawa
- Department of Thoracic Surgery, Inoue Hospital, Fukuyama, Hiroshima 721-0974, Japan
| | - Fumiyuki Inoue
- Department of Thoracic Surgery, Inoue Hospital, Fukuyama, Hiroshima 721-0974, Japan
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Hara K, Izumi N, Tsukioka T, Komatsu H, Toda M, Miyamoto H, Suzuki S, Kimura T, Shibata T, Nishiyama N. Solitary splenic metastasis from lung adenocarcinoma: A case report. Thorac Cancer 2017; 8:539-542. [PMID: 28731531 PMCID: PMC5582484 DOI: 10.1111/1759-7714.12477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/11/2017] [Accepted: 06/13/2017] [Indexed: 12/05/2022] Open
Abstract
Solitary splenic metastasis is extremely rare, with only 27 reported cases in the literature. An 81‐year‐old woman was referred to our hospital for treatment of pulmonary and splenic lesions. Chest computed tomography showed a small lung nodule in the right upper lobe, abdominal computed tomography showed an 8 cm splenic mass with abnormal accumulation, and positron emission tomography revealed a maximum standardized uptake value of 7.9. She had elevated serum cancer antigen 19‐9 (1847 U/mL) and carcinoembryonic antigen concentrations (17.9 ng/mL). She underwent laparoscopic splenectomy. Pathological examination revealed poorly differentiated adenocarcinoma. We performed partial lung resection and diagnosed the small lung lesion as lung adenocarcinoma. Both lesions were positive for thyroid transcription factor 1. Thus, primary lung adenocarcinoma and solitary splenic metastasis were diagnosed. The patient was still alive without recurrence four years postoperatively. Herein, we report a rare case of lung adenocarcinoma with solitary splenic metastasis and review the literature.
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Affiliation(s)
- Kantaro Hara
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Michihito Toda
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Toshihiko Shibata
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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Mitsimponas N, Mitsogianni M, Crespo F, Hartmann KA, Diederich S, Klosterhalfen B, Giagounidis A. Isolated Splenic Metastasis from Non-Small-Cell Lung Cancer: A Case Report and Review of the Literature. Case Rep Oncol 2017; 10:638-643. [PMID: 28868024 PMCID: PMC5567076 DOI: 10.1159/000478002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 12/22/2022] Open
Abstract
Metastases to the spleen are rare but have been reported for different tumor entities, including breast cancer, lung cancer, colorectal cancer, ovarian cancer, and melanoma. As an isolated event, splenic metastasis from non-small-cell lung cancer (NSCLC) is exceedingly rare. Until now, only 28 cases have been reported in the medical literature. We report the case of a 66-year-old woman with NSCLC (adenocarcinoma) who presented with a synchronous, isolated splenic metastasis. Operative removal of both primary tumor and metastasis was not possible due to multiple comorbidities. Therefore, treatment was limited to combined systemic chemotherapy and simultaneous radiation of the primary tumor, which led to partial remission of the disease. Isolated metastasis to the spleen in NSCLC has been reported only 28 times in the medical literature, most often in male patients with right-sided lung tumors, most of which were adenocarcinomas. The majority of patients were asymptomatic with respect to splenic metastasis. About half of the reported cases were isolated metachronous splenic metastases. Splenectomy seems to confer a survival advantage. We review the pertinent medical literature.
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Affiliation(s)
- Nikolaos Mitsimponas
- Department of Oncology, Hematology and Palliative Care, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Maria Mitsogianni
- Department of Oncology, Hematology and Palliative Care, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Felipe Crespo
- Department of Oncology, Hematology and Palliative Care, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Karl-Axel Hartmann
- Department of Radiation Therapy and Radiation Oncology, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Stefan Diederich
- Department of Radiology, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | | | - Aristoteles Giagounidis
- Department of Oncology, Hematology and Palliative Care, Marien Hospital Düsseldorf, Düsseldorf, Germany
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Iguchi K, Ishibashi O, Kondo T, Kagohashi K, Takayashiki N, Satoh H. Isolated spleen recurrence in a patient with lung adenocarcinoma: A case report. Exp Ther Med 2015; 10:733-736. [PMID: 26622384 DOI: 10.3892/etm.2015.2524] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 05/01/2015] [Indexed: 11/05/2022] Open
Abstract
Spleen metastasis is extremely rare in patients with lung cancer. However, recent improvements in imaging modalities may enable the antemortem diagnosis of spleen metastasis. The present study reports the case of a female patient with lung adenocarcinoma and spleen metastasis. The patient developed isolated spleen metastasis in the postoperative course. This rare metastasis was detected in a follow-up abdominal computed tomography (CT) scan without any symptoms, and was confirmed by fluorodeoxyglucose positron emission tomography (FDG-PET)/CT scan. Although very rare, chest physicians and thoracic surgeons should be alert to the possibility of spleen metastasis development when evaluating the follow-up abdominal CT scan. FDG-PET/CT scanning and an interventional approach should be considered to clarify the possibility of spleen metastasis.
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Affiliation(s)
- Kesato Iguchi
- Division of Surgery, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Osamu Ishibashi
- Division of Surgery, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Tadashi Kondo
- Division of Surgery, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Katsunori Kagohashi
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Norio Takayashiki
- Division of Pathology, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
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Laparoscopic management for carcinoid metastasis to the spleen. HPB SURGERY : A WORLD JOURNAL OF HEPATIC, PANCREATIC AND BILIARY SURGERY 2011; 2011:346507. [PMID: 21760662 PMCID: PMC3132497 DOI: 10.1155/2011/346507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 01/31/2011] [Accepted: 02/12/2011] [Indexed: 01/09/2023]
Abstract
We report a rare case of a laparoscopic splenectomy performed for a carcinoid metastasis. The patient represented with pleuritic left-sided chest pain from pleural deposits 9 years following resection of a primary lung carcinoid tumour. They were found to have a 4.7 cm splenic lesion on CT with a probable left acetabular metastasis demonstrated on Gallium PET scan. The patient underwent laparoscopic splenectomy for debulking treatment of the splenic lesion that was confirmed to be a splenic metastasis of the resected carcinoid lung tumour. Following an uncomplicated recovery, the patient was discharged on the second postoperative day. On discharge, she received adjuvant therapy with Lutetium 177 DOTATATE. This is the first report of a carcinoid splenic metastasis successfully treated with laparoscopic splenectomy.
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Chloros D, Bitzikas G, Kakoura M, Chatzikostas G, Makridis C, Tsitouridis I. Solitary splenic metastasis of squamous lung cancer: a case report. CASES JOURNAL 2009; 2:9091. [PMID: 20062728 PMCID: PMC2803888 DOI: 10.1186/1757-1626-2-9091] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Accepted: 11/25/2009] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lung cancer is the second commonest malignant tumour, with its splenic metastasis being a rare event. CASE PRESENTATION We report an exceedingly rare case of a moderate-to-low differentiation squamous cell lung carcinoma in a middle-aged man with a large solitary splenic metastasis detected simultaneously with the primary tumour. Surgical removal of both the primary tumour and the solitary splenic metastasis offered the patient the best treatment option. CONCLUSION The significance of the present case lies on the one hand in the appearance of a large solitary splenic metastasis from a squamous lung cancer at the time of its initial presentation and on the other in the successful excision of both lesions simultaneously.
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Affiliation(s)
- Diamantis Chloros
- Lung Unit, Papageorgiou Hospital, Ring Road N Efkarpia, Thessaloniki 56403, Greece
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Sánchez-Romero A, Oliver I, Costa D, Orduña A, Lacueva J, Pérez-Vicente F, Arroyo A, Calpena R. Giant splenic metastasis due to lung adenocarcinoma. Clin Transl Oncol 2006; 8:294-5. [PMID: 16648107 DOI: 10.1007/bf02664942] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Lung cancer is the most prevalent malignancy in western countries and most of the patients present at advanced stages, but single splenic metastasis is exceptional instead. We report on a case of a seventy- three-year old male presenting with non-hemoptoic productive cough, constitutional syndrome and pain in the left lower quadrant. Physical examination and complementary radiological and histological procedures revealed the presence of an adenocarcinoma of the left lung with probable splenic metastasis. The patient underwent splenectomy, which confirmed the diagnose of splenic metastasis of lung adenocarcinoma and, secondly, lung resection was performed. Topics about lung cancer metastasis are discussed.
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Affiliation(s)
- Ana Sánchez-Romero
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Elche, Alicante, Spain.
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