title: CT appearances and prognostic significance of splenic metastasis in ovarian cancer.
abstract: METHODS
  A retrospective review of women undergoing computed tomography (CT) as part of the investigation and management of pathologically proven ovarian cancer in a single specialist gynaecological cancer centre.
  
  
  OBJECTIVE
  To ascertain CT appearances and prognostic significance of splenic involvement in ovarian cancer.
  
  
  RESULTS
  We found a 10.3% frequency of splenic metastasis in a series of 321 patients with ovarian cancer. Thirty-three women had splenic metastases demonstrated on CT. Twenty-three women had surface lesions with an irregular scalloped shape and broad contact with the splenic surface; 17 of these women had lesions at presentation. Ten women had parenchymal lesions, five at presentation and five at relapse, typically with a rounded shape surrounded by normal splenic tissue. Four out of 10 cases with parenchymal involvement showed lesion progression during chemotherapy. However, lesion progression occurred in only one of 23 cases with surface disease (P < 0.025, Fisher's exact test). In 16 cases with disease involving both spleen and liver, the response to chemotherapy was the same in both organs.
  
  
  CONCLUSIONS
  We have found a higher frequency of splenic metastasis from ovarian cancer during life than previously reported. Parenchymal lesions are significantly less likely to respond to treatment than surface lesions but are more commonly a feature of relapsed disease. We have demonstrated that splenic metastases behave similarly to liver metastases in ovarian cancer. We suggest that the presence of splenic parenchymal metastasis is indicative of FIGO stage IV disease. This finding has implications for proposed cytoreductive surgery.
authors.affiliation: St James's University Hospital Gynaecological Oncology Unit, St. James's University Hospital, Leeds, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Spencer
authors.forename: J A
authors.initials: JA
authors.lastname: Spencer
authors.forename: T J
authors.initials: TJ
authors.lastname: Perren
authors.forename: G
authors.initials: G
authors.lastname: Lane
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary*; D014057:Tomography, X-Ray Computed