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直肠癌手术后孤立性异时性脾转移:一例报告并文献复习

Isolated metachronous splenic metastasis after rectal cancer surgery: a case report and literature review.

作者信息

Ren Peide, Shi Yihang, Zhang Letian, Sun Yuemin, Ye Zhibin, Liu Hengchang, Wang Shunda, Chen Yinggang

机构信息

Department of Gastrointestinal Surgery, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.

Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Front Oncol. 2025 Aug 7;15:1563632. doi: 10.3389/fonc.2025.1563632. eCollection 2025.

Abstract

BACKGROUND

The occurrence of isolated splenic metastasis in association with colorectal cancer is exceedingly rare. This paper presents a case of isolated splenic metastasis identified one year after radical resection of rectal cancer. The patient underwent laparoscopic splenectomy, achieving favorable therapeutic outcomes. Furthermore, we conduct a literature review of analogous cases and examine the clinical diagnosis and therapeutic approaches for this uncommon condition.

CASE REVIEW

A 76-year-old male patient underwent laparoscopic radical resection for rectal cancer, accompanied by ileostomy, at our institution. Postoperatively, the patient received two cycles of XELOX chemotherapy but continued with oral capecitabine for six cycles due to oxaliplatin intolerance. Follow-up enhanced CT scans of the chest, abdomen, and pelvis revealed an isolated metastatic tumor in the spleen. Subsequently, the patient underwent laparoscopic splenectomy. Histopathological examination post-surgery confirmed the metastasis of rectal cancer to the spleen.

CONCLUSION

Isolated splenic metastasis originating from colorectal cancer is exceedingly rare, and laparoscopic splenectomy constitutes an effective treatment strategy.

摘要

背景

结直肠癌伴孤立性脾转移极为罕见。本文报告1例直肠癌根治术后1年发现的孤立性脾转移病例。该患者接受了腹腔镜脾切除术,取得了良好的治疗效果。此外,我们对类似病例进行了文献回顾,并探讨了这种罕见疾病的临床诊断和治疗方法。

病例回顾

一名76岁男性患者在我院接受了腹腔镜直肠癌根治术并伴有回肠造口术。术后,患者接受了两个周期的XELOX化疗,但由于对奥沙利铂不耐受,继续口服卡培他滨六个周期。胸部、腹部和盆腔的随访增强CT扫描显示脾脏有一个孤立的转移瘤。随后,患者接受了腹腔镜脾切除术。术后组织病理学检查证实直肠癌转移至脾脏。

结论

结直肠癌源性孤立性脾转移极为罕见,腹腔镜脾切除术是一种有效的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d731/12367473/94ea854ae5cc/fonc-15-1563632-g001.jpg

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