title: [Isolated splenic metastases from cervical cancer: a rare entity].
abstract: BACKGROUND
  Splenic metastases from solid tumors are a rare event with an incidence of only 2.9% to 9%. Splenic metastases from cervical cancer are a rare entity. Only a few cases have been reported of isolated spleen metastases from cervical cancer.
  
  
  METHODS
  We present the case of a 76-year-old woman with moderately differentiated endocervical adenocarcinoma stromal and endocervical invasion. Clinical stage was Ib1 and Ca-125 values of 150 U. She was managed with hysterectomy and pelvic lymphadenectomy. She received pelvic radiotherapy (45 Gy) followed 24 Gy of brachytherapy. Two years later she presented with abdominal pain. Abdominal computed tomography showed two splenic parenchymal lesions without disease in the remainder of the abdominal cavity and chest with a Ca-125 of 2,733 U. The patient is submitted to splenectomy. Histopathology demonstrates splenic metastases of well-differentiated adenocarcinoma from the endocervix. Immunohistochemical stain showed positivity from carcinoembryonic antigen; estrogen and progesterone receptors are negative. Ca-125 level 8 weeks after surgery was 16 U/ml. The patient received six cycles of adjuvant chemotherapy with paclitaxel and cisplatin. At 12 months follow-up the patient is alive and without evidence of tumor activity.
  
  
  CONCLUSIONS
  The spleen is an uncommon site of metastasis. Splenectomy is considered the appropriate treatment in order to avoid complications such as splenic rupture and splenic vein thrombosis as well as to improve pain control from splenomegaly. Twelve months after surgery our patient is alive and without evidence of tumor activity.
authors.affiliation: Oncología quirúgica, Unidad Médica de Alta Especialidad 48, Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, Mexico. jsvillalon@yahoo.com.
authors.forename: José Sebastián
authors.initials: JS
authors.lastname: Villalón-López
authors.affiliation: Radioterapia, Unidad Médica de Alta Especialidad 1, Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, Mexico.
authors.forename: Rosalía
authors.initials: R
authors.lastname: Souto-del Bosque
authors.affiliation: Oncología Médica, Unidad Médica de Alta Especialidad 1, Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, Mexico.
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Montañez-Lugo
authors.affiliation: Patología, Unidad Médica de Alta Especialidad 1, Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, Mexico.
authors.forename: Bruno
authors.initials: B
authors.lastname: Chávez-González
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D017239:Paclitaxel / Q000008:administration & dosage; D012074:Remission Induction; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery
chemical_list: D017239:Paclitaxel; D002945:Cisplatin
keywords: Cervical cancer; cáncer cervicouterino; esplenectomía; metástasis esplénicas; splenectomy; splenic metastasis