Isolated Splenic Metastasis from Ovarian Carcinoma
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CASE REPORT
Isolated Splenic Metastasis from Ovarian Carcinoma Silpa S. Kumar1 • Fathima Nazarudeen1 • Anupama Rajanbabu2 • Keechilat Pavithran3 Received: 2 June 2020 / Revised: 27 July 2020 / Accepted: 11 August 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Introduction Isolated Splenic metastasis from ovarian cancer rarely occurs with only very few cases recorded in the literature. It can occur as a synchronous metastasis or as late as 20 years post-primary debulking surgery. Case Report A 62-year-old woman with carcinoma ovary stage IIIC was treated with primary debulking surgery in 2009, followed by six cycles of chemotherapy. In 2013, she was found to have an elevated serum CA-125 level during her regular follow-up. Imaging with CT scan abdomen showed a hyperdense lesion in splenic parenchyma of 2.1 9 2.4 cm. She underwent laparoscopic splenectomy. Histopathological examination revealed adenocarcinoma localised to the spleen, consistent with metastasis carcinoma ovary. Post-splenectomy, her CA-125 level returned to normal. Over the last 6 years, she is on regular follow-up and remains disease-free. Conclusion Isolated, solitary splenic metastasis from epithelial ovarian cancer is very rare. It occurred after a DFI of 4 years and was successfully treated and is remaining disease-free without any chemotherapy for the last 7 years. Keywords Isolated spleen metastasis Ovarian cancer Laparoscopic splenectomy
Introduction The spleen is the largest lymphoid tissue in the body, but it is not a common site of metastasis in patients with ovarian cancer [1]. Malignancies that frequently metastasise to spleen arise from colon, breast, lung, melanoma, ovarian and uterine cancers. According to the clinicopathologic studies in populations with carcinoma, splenic metastases from non-hematologic malignancies are very rare, with an incidence rate of about 0.6–1.1% [2]. Splenic metastasis generally occurs as part of multi-visceral metastatic disease [3]. They can present simultaneously or after as long as 20 years of post-primary debulking surgery [4]. They may & Keechilat Pavithran [email protected] 1
Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
2
Department of Gynecologic Oncology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
3
Department of Medical Oncology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
present with painful splenomegaly or fully asymptomatic and detected only during routine follow-up. Here we report a 62-year-old lady with isolated, solitary splenic metastasis occurring after a DFI of 4-years and was successfully treated and is remaining disease-free without any chemotherapy for the last 7 years.
Case Report A 62-year-old female, presented with complaints of abdominal distension of 1-week duration. CT scan abdomen done on 24 October 2009 showed a compl
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