[A rare case of metastasis of the spleen from recurrent cancer of the residual stomach].
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.
Fujita
M
M
Dept. of Surgery, Hakodate Municipal Hospital.
Yamazaki
S
S
Morioka
G
G
Machida
J
J
Ochiai
K
K
Ozawa
M
M
Ohtsuki
H
H
Shimoyama
N
N
Ishidate
T
T
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*