Department of Hepatobiliary Surgery, Xiamen University Zhongshan Hospital, 209 South Hubin Road, 361004, Xiamen, PR China.
Surg Today. 2011 Jun;41(6):854-8. doi: 10.1007/s00595-010-4336-7. Epub 2011 May 28.
Solitary carcinomatous metastases to the spleen are rare, and the presence of solitary splenic metastasis of hepatoid adenocarcinomas (HAC) has not yet been reported. We herein present the case of a 54-year-old male patient who developed a metastatic tumor to the spleen with enhanced levels of serum α-fetoprotein and carcinoembryonic antigen (CEA). The patient underwent a gastrectomy due to adenocarcinoma of the stomach 5 years previously. The tumor was diagnosed on the grounds of histopathology and immunohistochemical staining after splenectomy. The pathology slides showed both adenocarcinoma and hepatoid structures. α-Fetoprotein antibody staining was positive in the tumor, suggesting hepatoid characteristics. After the operation, the patient recovered well and had no signs of recurrence at a follow-up examination after 9 months. Together with this case, several aspects of the disease are discussed after a review of the current literature.
脾脏孤立性癌转移较为罕见,而肝样腺癌(HAC)的脾脏孤立性转移尚未见报道。本文报道了 1 例 54 岁男性患者,其因血清 α-胎蛋白和癌胚抗原(CEA)水平升高而发生脾脏转移瘤。该患者 5 年前因胃腺癌行胃切除术。术后根据病理组织学和免疫组织化学染色诊断为肿瘤。病理切片显示既有腺癌又有肝样结构。肿瘤的甲胎蛋白抗体染色阳性,提示具有肝样特征。术后患者恢复良好,9 个月后的随访检查未见复发迹象。结合本病例,并复习文献,对该病的几个方面进行了讨论。