Ando Katsutoshi, Kaneko Norihiro, Yi Lina, Sato Chieko, Yasui Daisaku, Inoue Keiichi, Misawa Masafumi, Ohkuni Yoshihiro
Department of Pulmonology, Kameda Medical Center.
Nihon Kokyuki Gakkai Zasshi. 2009 Jul;47(7):581-4.
A 71-year-old man was referred for a chest x-ray of the right upper lobe lung mass in August 2005. Bronchoscopy and transbronchial biopsy revealed squamous cell carcinoma. A routine metastatic workup revealed his clinical stage to be IIIA (cT2N2M0). We treated him with chemotherapy and radiotherapy. However, an abdominal CT scan showed an 8 cm nodule in the spleen in June 2006. Splenic metastasis from lung cancer is rare. Only 13 cases have been reported from 1990 to 2008. Four of 6 cases (67%) who did not have splenectomy reported splenic rupture and had poor outcomes. Therefore, we considered that splenectomy could possibly improve the prognosis of this patient with isolated splenic metastasis. We report a case with a brief review of the literature and summarize the 13 reported cases.
一名71岁男性于2005年8月因右上叶肺肿块接受胸部X光检查。支气管镜检查和经支气管活检显示为鳞状细胞癌。常规的转移灶检查显示其临床分期为IIIA期(cT2N2M0)。我们对他进行了化疗和放疗。然而,2006年6月的腹部CT扫描显示脾脏有一个8厘米的结节。肺癌脾转移很少见。1990年至2008年仅有13例报告。6例未行脾切除术的患者中有4例(67%)发生脾破裂且预后不良。因此,我们认为脾切除术可能会改善这名孤立性脾转移患者的预后。我们报告一例病例,并简要回顾文献,总结13例报告病例。