title: [A rare case of metastasis of the spleen from recurrent cancer of the residual stomach].
abstract: In May, 1988, a 75-year-old housewife, who had undergone a subtotal gastrectomy for a carcinoma 12 years earlier, visited our hospital because of vomiting. Biopsy specimens of the residual gastric mucosa revealed malignant cells and an abdominal CT scanning examination showed a solitary nodule in the splenic parenchyma. A non-curative resection of the residual stomach, a splenectomy and a distal pancreatectomy were performed on June 3, 1988. Histological examination of the resected specimens demonstrated a moderately differentiated adenocarcinoma of the stomach, that had invaded the pancreas and retroperitoneal nodes. A nodule of the spleen that was inspected showed a round, greyish solid mass, 0.7 cm in diameter on the cut surface, and microscopically metastatic focus from a gastric cancer. Only a few operated cases manifesting a splenic metastasis of a gastric cancer have been reported and a definitive routing pattern of the metastasis is often difficult to distinguish. However, our case seems to suggest that a hemodynamic route had been taken, since there were no metastatic nodes around the splenic hilus and the metastatic site was only the parenchyma in the spleen.
authors.affiliation: Dept. of Surgery, Hakodate Municipal Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Fujita
authors.forename: S
authors.initials: S
authors.lastname: Yamazaki
authors.forename: G
authors.initials: G
authors.lastname: Morioka
authors.forename: J
authors.initials: J
authors.lastname: Machida
authors.forename: K
authors.initials: K
authors.lastname: Ochiai
authors.forename: M
authors.initials: M
authors.lastname: Ozawa
authors.forename: H
authors.initials: H
authors.lastname: Ohtsuki
authors.forename: N
authors.initials: N
authors.lastname: Shimoyama
authors.forename: T
authors.initials: T
authors.lastname: Ishidate
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary*; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D011184:Postoperative Period; D013160:Splenic Neoplasms / Q000473:pathology / Q000556:secondary*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*