Jain Sarika, Munjal Sumeet, Yantiss Rhonda K, Sonoda Toyooki, Fahey Thomas J, Ruggiero Joseph T, Anand Alok, Gersten Adam, Goldsmith Stanley J, Ocean Allyson J
Departments of Medicine, Weill Cornell Medical College, New York, N.Y., USA.
Case Rep Oncol. 2011 Sep;4(3):499-504. doi: 10.1159/000333446. Epub 2011 Sep 4.
The presence of isolated splenic metastasis in rectal carcinoma is uncommon and usually presents as an asymptomatic mass, noted incidentally on imaging. Splenectomy is usually performed with the goal of curing metastatic disease. It is unclear if adjuvant chemotherapy affords any benefit, and the prognosis is unknown. The case of a young woman is reported, in whom an isolated metastatic lesion in the spleen was discovered 9 months after adjuvant chemotherapy for stage III rectal adenocarcinoma. The patient has remained disease-free for nearly 5 years following splenectomy and chemotherapy. To our knowledge, this is the fourth reported case in the English literature of an isolated splenic metastatic lesion from rectal cancer. We discuss the unique presentation, the importance of post-treatment surveillance, and the implementation of multi-modality treatment strategies in this young patient.
直肠癌孤立性脾转移并不常见,通常表现为无症状肿块,在影像学检查时偶然发现。脾切除术通常以治愈转移性疾病为目的进行。目前尚不清楚辅助化疗是否有益,预后也未知。本文报道了一名年轻女性的病例,她在接受III期直肠腺癌辅助化疗9个月后发现脾脏有孤立性转移灶。该患者在脾切除和化疗后已无病生存近5年。据我们所知,这是英文文献中第四例报道的直肠癌孤立性脾转移灶病例。我们讨论了该病例的独特表现、治疗后监测的重要性以及针对这位年轻患者实施的多模式治疗策略。