A CASE OF RECTAL CANCER METASTASIZING TO THE SPLEEN

The spleen is rarely involved by metastatic carcinoma, especially by colon cancer. This paper reports a recent case of rectal cancer (Rs) with a solitary splenic metastasis.The patient was a 62-year-old male with high serum level of CEA (15.1 ng/ml). Histological examination revealed Borrmann 2 type and moderately differentiated adenocarcinoma characterized by s, n (+), INF-β, ly2, v1. Two metastatic lesions were found in the right lobe of the liver and one in the left lobe. A solitary metastasis of 5.0×4.0 cm was found in the lower pole of the spleen. In addition to anterior resection (R3), splenectomy was performed. Further the metastatic lesion in the left lobe was enucleated, and a catheter of the injection port was inserted into the right gastroepiploic artery for chemotherapy. Four months after the operation the patient is still in good health. A review of the literature showed only 13 reports on colon cancer with splenic metastases. In all these cases, preoperative serum CEA levels were extremely high. This demands consideration of possible splenic metastases in patients with high CEA values, but without hepatic or pulmonary metastasis. To say more about prognosis for such cases, further case studies will be required.