Zayed Mohamed A, Kosek Jon, Wren Sherry M
Department of Surgery, Stanford University Medical Center, Stanford, CA;
Rare Tumors. 2011 Oct 21;3(4):e43. doi: 10.4081/rt.2011.e43. Epub 2011 Oct 13.
A 57-year-old with a 9-year history of increased abdominal girth, presented with increased abdominal pain, anemia, and acute renal failure. His past medical history was only remarkable for a previous lung cancer 21 years ago that was treated with a right upper lung lobectomy. A computed tomography (CT) scan of the patient's abdomen showed a solitary 20×20×25cm cystic splenic mass. The patient underwent an urgent splenectomy. Intra-operatively a large splenic cystic cavity was found with a solid inferior splenic mass. An exhaustive histological analysis of the splenic mass confirmed a clear cell carcinoma with low malignant potential that likely represented a metastatic lesion from the patient's previous distant lung cancer. Postoperatively the patient recovered well and at 1-year followup the patient demonstrated no further evidence of metastatic disease. This case is extremely unique and provides a very rare example of a metastatic solitary clear cell carcinoma to the spleen, with a presumed latency period of more than 20 years.
一名57岁男性，有9年腹围增大病史，现出现腹痛加剧、贫血和急性肾衰竭。他既往病史仅21年前曾患肺癌，行右上肺叶切除术。患者腹部计算机断层扫描（CT）显示脾脏有一个20×20×25cm的孤立性囊性肿块。患者接受了急诊脾切除术。术中发现一个大的脾囊肿腔，脾下极有实性肿块。对脾脏肿块进行详尽的组织学分析，证实为低恶性潜能的透明细胞癌，可能是患者既往远处肺癌的转移灶。术后患者恢复良好，1年随访时未发现转移疾病的进一步证据。该病例极为独特，是脾脏转移性孤立性透明细胞癌的罕见例子，推测潜伏期超过20年。
