title: Solitary metastatic clear cell carcinoma to the spleen.
abstract: A 57-year-old with a 9-year history of increased abdominal girth, presented with increased abdominal pain, anemia, and acute renal failure. His past medical history was only remarkable for a previous lung cancer 21 years ago that was treated with a right upper lung lobectomy. A computed tomography (CT) scan of the patient's abdomen showed a solitary 20×20×25cm cystic splenic mass. The patient underwent an urgent splenectomy. Intra-operatively a large splenic cystic cavity was found with a solid inferior splenic mass. An exhaustive histological analysis of the splenic mass confirmed a clear cell carcinoma with low malignant potential that likely represented a metastatic lesion from the patient's previous distant lung cancer. Postoperatively the patient recovered well and at 1-year followup the patient demonstrated no further evidence of metastatic disease. This case is extremely unique and provides a very rare example of a metastatic solitary clear cell carcinoma to the spleen, with a presumed latency period of more than 20 years.
authors.affiliation: Department of Surgery, Stanford University Medical Center, Stanford, CA;
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Zayed
authors.forename: Jon
authors.initials: J
authors.lastname: Kosek
authors.forename: Sherry M
authors.initials: SM
authors.lastname: Wren