Prethodno priopćenje
Isolated Splenic Metastasis from Colorectal Carcinoma in a High Risk Patient: A Case Report
Mirjana Pavlović
Robert Šeparović
Mirjana Vukelić-Marković
Leonardo Patrlj
Marijan Kolovrat
Mario Kopljar
Nenad Babić
Dragutin Košuta
Žarko Babić
Sažetak
Isolated splenic metastasis arising from a colorectal carcinoma is a rare finding. We report a case of 74-year-old man
with a medical history od diabetes type II and paroxysmal atrial fibrillation, who underwent a right hemicolectomy for
an adenocarcinoma of caecum in August 2004. In June 2007 the patient was diagnosed with high grade aortic valve stenosis
as well as long segment stenosis of the first obtuse marginal branch of left coronary artery. He was suggested aortic
valve replacement with coronary artery bypass grafting but he refused the surgery. In October 2007 the patient underwent
a 18FDG – PET scanning, due to increasing values of CEA serum level, which showed a 5 cm big isolated hypermetabolic
lesion in the spleen. Due to operative risk, splenectomy was refused by surgeons. The patient underwent a chemotherapy
with capecitabine in total of 8 cycles before his CEA level began to rise and MSCT showed a progression in size of
splenic metastasis. The patients condition was reevaluated by a team of experts and splenectomy was performed in September
2008. In May 2009 during the postoperative follow up, MSCT scanning revealed enlarged lymph nodes in celiac
region and hepatic lesion suspicious of metastasis and the patient was addmited for further chemotherapy treatment.
There is still no standardized treatment for this condition due to small number of cases reported in literature. Splenectomy
followed by chemotherapy seems to be an optimal treatment but still no final conclusions can be made.
Ključne riječi
splenic metastasis; colorectal cancer; splenectomy; Zagreb; Croatia
Hrčak ID:
75676
URI
Datum izdavanja:
30.12.2011.
Posjeta: 1.434 *