A CASE REPORT OF RESECTED SOLITARY SPLENIC METASTASIS WITH SUBCAPSULAR BLEEDING FROM COLONIC CARCINOMA

概要

論文の詳細を見る
There are 30 reports on colonic carcinoma with splenic metastasis in the Japanese literature and the hematogeneous route of splenic metastasis has been suggested. We report a case of resected solitary splenic metastasis with subcapsular bleeding after resection of carcinoma of the descending colon. A 76-year-old male underwent resection of a pulmonary tumor in the left lobe on March 14, 1994 and right hemicolectomy for carcinoma of the descending colon on April 20, 1994. Histology revealed well differentiated adenocarcinoma of the colon with pulmonary metastasis, judged to be stage IV (ss, n1(+), P0, H0, M(+)), as proposed by the Japanese Colorectal Society. The serum CEA level rose again, reaching 7.3ng/ml six months later. Results of abdominal computed tomography showed a splenic tumor, 4.0×3.0cm in diameter. Ultrasonography revealed the tumor to have a round mosaic echoic area pattern. He rejected splenectomy for the metastatic lesion. Sudden left upper abdominal pain developed on September 5, 1995. Computed tomography and ultrasonography showed rupture of the splenic tumor with subcapsular bleeding. The patient thus accepted operation. A splenectomy was performed on September 25, 1995. Histological findings of the resected splenic tumor revealed the same histological type as the primary colonic lesion.
日本臨床外科学会の論文