Solitary splenic metastasis from early gastric cancer: Report of a case
Solitary splenic metastasis from early gastric cancer: Report of a case
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DOI：
10.1007/s00595-008-4002-5
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发表时间：
2010-01-01
期刊：
影响因子：
2.5
通讯作者：
Nagawa, Hirokazu
中科院分区：
文献类型：
--
作者：
Kawasaki, Hiroshi;Kitayama, Joji;Nagawa, Hirokazu
孤立性转移至脾的恶性肿瘤是罕见的。我们在此描述一例早期胃癌的脾转移。一位76岁的男性接受了胃镜黏膜切除术(EMR)的早期胃癌在贲门。病理上，肿瘤侵犯粘膜下层，手术标本残端呈恶性细胞阳性。因此，他接受了近端胃切除加结节清扫术。一年后，血清癌胚抗原升高，计算机断层扫描和超声检查发现脾肿块。由于肿瘤逐渐增大，其他部位也未发现转移灶，因此我们进行了脾切除术。病理诊断为先前胃癌的转移，在脾切除2年多后，患者至今仍健康，没有复发。在胃癌患者的术后随访中，当怀疑有脾孤立性转移时，脾切除术是一种潜在的有效治疗方法。
Solitary metastasis of a malignancy to the spleen is rare. We herein describe a case of splenic metastasis from early gastric cancer. A 76-year-old man underwent an endoscopic mucosal resection (EMR) for early gastric carcinoma in the cardia. Pathologically, the tumor showed invasion into the submucosal layer, and the stump of the surgical specimen appeared to be positive for malignant cells. He thus underwent a proximal gastrectomy with nodal dissection. One year later, serum carcinoembryonic antigen was elevated, and a splenic mass was detected by computed tomography and ultrasonography. Because the tumor increased in size very gradually and no metastatic lesions were detected at the other sites, we performed a splenectomy. The lesion was pathologically diagnosed as metastasis from the previous gastric carcinoma, and the patient remains healthy to date without recurrence, more than 2 years after the splenectomy. When solitary metastasis to the spleen is suspected during the postoperative follow-up of a patient with gastric cancer, a splenectomy is a potentially effective treatment.