Kang Dongxue, Zhao Danyang, Jiang Xiaodi, Li Deming
Department of Operating Room, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
Department of Emergency, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
Front Oncol. 2023 May 3;13:1079044. doi: 10.3389/fonc.2023.1079044. eCollection 2023.
Metastases to the spleen from various non-hematologic malignancies are generally not a common clinical event and usually indicate the late dissemination of disease. Solitary splenic metastases from solid neoplasm are extremely uncommon. Furthermore, solitary metastasis to the spleen from primary fallopian tube carcinoma (PFTC) is extremely rare and has not been reported previously. We report a case of isolated splenic metastasis in a 60-year-old woman, occurring 13 months after a total hysterectomy, a bilateral salpingo-oophorectomy, a pelvic lymphadenectomy, a para-aortic lymphadenectomy, an omentectomy, and an appendectomy were performed for PFTC. The patient's serum tumor marker CA125 was elevated to 49.25 U/ml (N < 35.0 U/ml). An abdominal computed tomography (CT) scan revealed a 4.0 × 3.0 cm low-density lesion in the spleen that was potentially malignant, with no lymphadenectasis or distant metastasis. The patient underwent a laparoscopic exploration, and one lesion was found in the spleen. Then, a laparoscopic splenectomy (LS) confirmed a splenic metastasis from PFTC. The histopathological diagnosis showed that the splenic lesion was a high-differentiated serous carcinoma from PFTC metastasis. The patient recovered for over 1 year, with no tumor recurrence. This is the first reported case of an isolated splenic metastasis from PFTC. This case underlines the importance of serum tumor marker assessment, medical imaging examination, and history of malignancy during follow-up, and LS seems to be the optimal approach for isolated splenic metastasis from PFTC.
各种非血液系统恶性肿瘤转移至脾脏通常并非常见的临床事件，且往往提示疾病已发生晚期播散。实体肿瘤的孤立性脾转移极为罕见。此外，原发性输卵管癌（PFTC）孤立性转移至脾脏极为罕见，此前未见报道。我们报告一例60岁女性的孤立性脾转移病例，发生在因PFTC行全子宫切除术、双侧输卵管卵巢切除术、盆腔淋巴结清扫术、腹主动脉旁淋巴结清扫术、大网膜切除术和阑尾切除术后13个月。患者血清肿瘤标志物CA125升高至49.25 U/ml（正常范围<35.0 U/ml）。腹部计算机断层扫描（CT）显示脾脏有一个4.0×3.0 cm的低密度病灶，可能为恶性，无淋巴结转移或远处转移。患者接受了腹腔镜探查，在脾脏发现一个病灶。随后，腹腔镜脾切除术（LS）证实为PFTC脾转移。组织病理学诊断显示脾脏病灶为PFTC转移的高分化浆液性癌。患者康复超过1年，无肿瘤复发。这是首例报道的PFTC孤立性脾转移病例。该病例强调了随访期间血清肿瘤标志物评估、医学影像检查和恶性肿瘤病史的重要性，而LS似乎是PFTC孤立性脾转移的最佳治疗方法。
