Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan.
Thorac Cancer. 2017 Sep;8(5):539-542. doi: 10.1111/1759-7714.12477. Epub 2017 Jul 21.
Solitary splenic metastasis is extremely rare, with only 27 reported cases in the literature. An 81-year-old woman was referred to our hospital for treatment of pulmonary and splenic lesions. Chest computed tomography showed a small lung nodule in the right upper lobe, abdominal computed tomography showed an 8 cm splenic mass with abnormal accumulation, and positron emission tomography revealed a maximum standardized uptake value of 7.9. She had elevated serum cancer antigen 19-9 (1847 U/mL) and carcinoembryonic antigen concentrations (17.9 ng/mL). She underwent laparoscopic splenectomy. Pathological examination revealed poorly differentiated adenocarcinoma. We performed partial lung resection and diagnosed the small lung lesion as lung adenocarcinoma. Both lesions were positive for thyroid transcription factor 1. Thus, primary lung adenocarcinoma and solitary splenic metastasis were diagnosed. The patient was still alive without recurrence four years postoperatively. Herein, we report a rare case of lung adenocarcinoma with solitary splenic metastasis and review the literature.
孤立性脾转移极为罕见,文献中仅报告了 27 例。一位 81 岁女性因肺部和脾脏病变被转诊至我院治疗。胸部计算机断层扫描显示右上肺有一小肺结节,腹部计算机断层扫描显示 8cm 大小的脾脏肿块异常积聚,正电子发射断层扫描显示最大标准化摄取值为 7.9。她的血清癌抗原 19-9(1847U/mL)和癌胚抗原浓度升高(17.9ng/mL)。她接受了腹腔镜脾切除术。病理检查显示为低分化腺癌。我们进行了部分肺切除术,并将小的肺部病变诊断为肺腺癌。两个病变均对甲状腺转录因子 1呈阳性。因此,诊断为原发性肺腺癌和孤立性脾转移。术后 4 年,患者仍无复发,无病生存。在此,我们报告一例罕见的肺腺癌伴孤立性脾转移病例,并复习文献。