Metachronous solitary splenic metastasis arising from early gastric cancer: a case report and literature review.
Metachronous solitary splenic metastasis arising from early gastric cancer: a case report and literature review.
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早期胃癌引起的加值孤立性脾转移：病例报告和文献综述。
DOI：
10.1186/s12893-017-0292-0
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发表时间：
2017-08-29
期刊：
影响因子：
1.9
通讯作者：
Hanazaki K
中科院分区：
文献类型：
--
作者：
Namikawa T;Kawanishi Y;Fujisawa K;Munekage E;Munekage M;Sugase T;Maeda H;Kitagawa H;Kumon T;Hiroi M;Kobayashi M;Hanazaki K
恶性肿瘤转移到脾脏是罕见的，只有一小部分病例可以手术治疗，因为脾脏转移通常发生在晚期多脏器转移癌的背景下。我们报告一个早期胃癌发生异时性孤立性脾脏转移的罕见病例。一位75岁的男性最初被转诊到我院检查胃癌，在体检中确诊。食管胃内窥镜检查显示胃上三分之一处有轻微隆起的病变，伴有中央不规则凹陷。病灶的活组织检查显示为中分化腺癌，腹部电脑断层扫描显示无远处转移的证据。进行内镜下粘膜下剥离术，组织学证实中分化腺癌侵入粘膜下层。患者随后接受了腹腔镜全胃切除术和区域淋巴结清扫术，结果无残留癌和淋巴结转移。28个月后，计算机断层扫描显示脾脏中有一个直径4.2厘米的清晰肿块，由于没有证据表明任何其他器官有进一步的转移性病变，患者接受了脾切除术。组织学检查证实诊断为低分化腺癌起源于以前的胃癌。病人在手术切除脾脏转移瘤后存活了2个月，没有任何复发。据我们所知，这只是第二例孤立性脾转移从早期胃癌的英文文献报道。本病例提示手术切除可能是胃癌孤立性脾转移患者的首选治疗方法。
The metastasis of malignant tumors to the spleen is rare, and only a small percentage of cases can be treated surgically, as splenic metastases generally occur in the context of multivisceral metastatic cancer at a terminal stage. We report a rare case of metachronous solitary splenic metastasis arising from early gastric cancer. A 75-year-old man was initially referred to our hospital for examination of gastric cancer, diagnosed at a medical check-up. Esophagogastroduodenoscopy showed a slightly elevated lesion with a central irregular depression in the upper-third of the stomach. Biopsy specimens of the lesion showed a moderately-differentiated adenocarcinoma, and abdominal computed tomography showed no evidence of distant metastases. Endoscopic submucosal dissection was performed, with histological confirmation of a moderately-differentiated adenocarcinoma invading the submucosal layer. The patient subsequently underwent laparoscopic total gastrectomy with regional lymph node dissection, resulting in no residual carcinoma and no lymph node metastasis. Computed tomography, 28 months later, showed a well-defined mass measuring 4.2 cm in diameter in the spleen, and the patient underwent a splenectomy, since there was no evidence of further metastatic lesions in any other organs. Histological examination confirmed the diagnosis of a poorly-differentiated adenocarcinoma originating from the previous gastric cancer. The patient was alive 2 months after surgical resection of the splenic metastasis without any recurrence. To the best of our knowledge, this is only the second case of a solitary splenic metastasis from early gastric cancer to be reported in the English literature. The present case suggests surgical resection may be the preferred treatment of choice for patients with a solitary splenic metastasis from gastric cancer.
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影响因子：
3
作者：
Okabayashi, Takehiro;Kobayashi, Michiya;Hanazaki, Kazuhiro
通讯作者：
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DOI：
10.1007/s00432-008-0502-3
发表时间：
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影响因子：
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