A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer
Abstract Background Very rarely does a splenic solitary metastasis arise from a gastric carcinoma because splenic metastasis is usually seen in association with widespread visceral metastasis. Splenectomy is considered to be a curative treatment; however, long-term prognosis after splenectomy has sc...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-09-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12957-020-02024-1 |
| _version_ | 1818922480504406016 |
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| author | Ayato Obana Nobuo Komatsu Kazuma Aiba Shinya Nakanishi Masakazu Abe Toshiyuki Yamaguchi Masahiro Hayashi Hayato Obi Masamichi Koyama Shinichi Hashimoto |
| author_facet | Ayato Obana Nobuo Komatsu Kazuma Aiba Shinya Nakanishi Masakazu Abe Toshiyuki Yamaguchi Masahiro Hayashi Hayato Obi Masamichi Koyama Shinichi Hashimoto |
| author_sort | Ayato Obana |
| collection | DOAJ |
| description | Abstract Background Very rarely does a splenic solitary metastasis arise from a gastric carcinoma because splenic metastasis is usually seen in association with widespread visceral metastasis. Splenectomy is considered to be a curative treatment; however, long-term prognosis after splenectomy has scarcely been reported. We report a case of a metachronous and solitary metastasis to the spleen from gastric cancer in which the patient achieved 5-year recurrence-free survival after splenectomy. Case presentation An 84-year-old man underwent an open total gastrectomy involving D1+ lymph nodes dissection for gastric cancer located in the cardia (pT3N1M0, pStage IIB). Eighteen months later, a 2-cm solitary hypodense lesion was detected in the spleen by computed tomography (CT). Twenty-three months later, the serum carcinoembryonic antigen (CEA) value elevated to 19.9 ng/ml, and abdominal CT revealed an increase in tumor size to 5 cm. Positron-emission tomography (PET)-CT revealed intense 18F-2-deoxy-2-fluoro-glucose (FDG) uptake in the spleen without the involvement of other organs and lymph nodes. We diagnosed him with solitary splenic metastasis from gastric cancer and performed a splenectomy 26 months after the first surgery. Histological examination revealed that the splenic tumor was a moderately differentiated adenocarcinoma, which was very similar to the primary gastric tumor; the lesion was diagnosed as a metastatic tumor from the previous gastric carcinoma. The patient remains healthy to date without recurrence, 5 years after the splenectomy. Conclusion We experienced a case of a solitary splenic metastasis from gastric cancer in which 5-year recurrence-free survival was achieved after splenectomy. To determine the surgical indication in patients with splenic metastasis, it is important to differentiate between a solitary lesion or multiple metastasis. Especially, occult metastasis should be excluded by means of several months of follow-up with imaging tests and systemic FDG-PET surveys before splenectomy. |
| first_indexed | 2024-12-20T01:54:13Z |
| format | Article |
| id | doaj.art-668f23841e164e9ebb1daa4386ffd6da |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-20T01:54:13Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-668f23841e164e9ebb1daa4386ffd6da2022-12-21T19:57:32ZengBMCWorld Journal of Surgical Oncology1477-78192020-09-011811610.1186/s12957-020-02024-1A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancerAyato Obana0Nobuo Komatsu1Kazuma Aiba2Shinya Nakanishi3Masakazu Abe4Toshiyuki Yamaguchi5Masahiro Hayashi6Hayato Obi7Masamichi Koyama8Shinichi Hashimoto9Department of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterDepartment of Surgery, Asama Nanroku Komoro Medical CenterAbstract Background Very rarely does a splenic solitary metastasis arise from a gastric carcinoma because splenic metastasis is usually seen in association with widespread visceral metastasis. Splenectomy is considered to be a curative treatment; however, long-term prognosis after splenectomy has scarcely been reported. We report a case of a metachronous and solitary metastasis to the spleen from gastric cancer in which the patient achieved 5-year recurrence-free survival after splenectomy. Case presentation An 84-year-old man underwent an open total gastrectomy involving D1+ lymph nodes dissection for gastric cancer located in the cardia (pT3N1M0, pStage IIB). Eighteen months later, a 2-cm solitary hypodense lesion was detected in the spleen by computed tomography (CT). Twenty-three months later, the serum carcinoembryonic antigen (CEA) value elevated to 19.9 ng/ml, and abdominal CT revealed an increase in tumor size to 5 cm. Positron-emission tomography (PET)-CT revealed intense 18F-2-deoxy-2-fluoro-glucose (FDG) uptake in the spleen without the involvement of other organs and lymph nodes. We diagnosed him with solitary splenic metastasis from gastric cancer and performed a splenectomy 26 months after the first surgery. Histological examination revealed that the splenic tumor was a moderately differentiated adenocarcinoma, which was very similar to the primary gastric tumor; the lesion was diagnosed as a metastatic tumor from the previous gastric carcinoma. The patient remains healthy to date without recurrence, 5 years after the splenectomy. Conclusion We experienced a case of a solitary splenic metastasis from gastric cancer in which 5-year recurrence-free survival was achieved after splenectomy. To determine the surgical indication in patients with splenic metastasis, it is important to differentiate between a solitary lesion or multiple metastasis. Especially, occult metastasis should be excluded by means of several months of follow-up with imaging tests and systemic FDG-PET surveys before splenectomy.http://link.springer.com/article/10.1186/s12957-020-02024-1Splenic metastasisGastric cancerSplenectomy |
| spellingShingle | Ayato Obana Nobuo Komatsu Kazuma Aiba Shinya Nakanishi Masakazu Abe Toshiyuki Yamaguchi Masahiro Hayashi Hayato Obi Masamichi Koyama Shinichi Hashimoto A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer World Journal of Surgical Oncology Splenic metastasis Gastric cancer Splenectomy |
| title | A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer |
| title_full | A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer |
| title_fullStr | A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer |
| title_full_unstemmed | A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer |
| title_short | A case of long-term survival after splenectomy for solitary splenic metastasis from gastric cancer |
| title_sort | case of long term survival after splenectomy for solitary splenic metastasis from gastric cancer |
| topic | Splenic metastasis Gastric cancer Splenectomy |
| url | http://link.springer.com/article/10.1186/s12957-020-02024-1 |
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