Piura Ettie, Piura Benjamin
Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar Saba Affiliated to Sackler Medical School, University of Tel Aviv, Israel.
Harefuah. 2010 May;149(5):315-20, 335, 334.
Splenic metastases are rare. Usually, they are part of a disseminated disease and located on the splenic capsule. Common sources are breast cancer, lung cancer and malignant melanoma. SoLitary splenic metastases are rare, usuaLLy located in the splenic parenchyma and metastasizing via the hematogenous route. Splenic metastases from ovarian carcinoma are usuaLly part of a disseminated disease, located on the splenic capsule and metastasize via the peritoneum. Splenic metastases from endometriaL carcinoma are usuaLLy solitary, Located in the splenic parenchyma and metastasize via the hematogenous route. Splenic metastases from cervical carcinoma are divided equally between metastases as part of a disseminated disease and soLitary metastases. Less than 100 cases of solitary splenic metastases have been reported with half of them being metastases from female genital tract malignancies: 30--ovarian carcinoma; 11--endometriaL carcinoma; 8--cervical carcinoma; and 1--tubal carcinoma. Few cases have been reported of splenic rupture because of metastases from choriocarcinoma. Splenic metastases as part of a disseminated disease are associated with poor prognosis, and splenectomy--apart from cases in which it might assist in achieving optimaL debulking--is not effective. Solitary splenic metastases represent a more moderate disease and the treatment of choice is splenectomy. SoLitary splenic metastases may be detected after an interval from the diagnosis of the primary disease. Hence, patients who had been treated for female genital tract malignancy, even if they are asymptomatic, need a long-term follow-up, including serial imaging studies of the spleen.
脾转移瘤较为罕见。通常，它们是播散性疾病的一部分，位于脾包膜上。常见来源为乳腺癌、肺癌和恶性黑色素瘤。孤立性脾转移瘤罕见，通常位于脾实质内，通过血行途径转移。卵巢癌的脾转移瘤通常是播散性疾病的一部分，位于脾包膜上，通过腹膜转移。子宫内膜癌的脾转移瘤通常为孤立性，位于脾实质内，通过血行途径转移。宫颈癌的脾转移瘤在作为播散性疾病一部分的转移瘤和孤立性转移瘤之间分布均等。据报道，孤立性脾转移瘤少于100例，其中一半是女性生殖道恶性肿瘤的转移瘤：30例为卵巢癌；11例为子宫内膜癌；8例为宫颈癌；1例为输卵管癌。因绒毛膜癌转移导致脾破裂的病例报道较少。作为播散性疾病一部分的脾转移瘤预后较差，除了可能有助于实现最佳肿瘤减灭的情况外，脾切除术无效。孤立性脾转移瘤代表一种病情较轻的疾病，治疗选择是脾切除术。孤立性脾转移瘤可能在原发性疾病诊断后的一段时间后被发现。因此，曾接受过女性生殖道恶性肿瘤治疗的患者，即使无症状，也需要长期随访，包括对脾脏进行系列影像学检查。
