title: Surgical resection of splenic metastasis from the adenosquamous gallbladder carcinoma: A case report.
abstract: BACKGROUND
  Splenic metastasis of gallbladder carcinoma is extremely rare. Specific anatomical, histological, and functional properties of spleen are believed to be responsible for the rarity of solitary splenic metastasis.
  
  
  METHODS
  We present the case of a 62-year-old female who developed metachronous splenic metastasis of adenosquamous carcinoma of the gallbladder. We performed central bisegmentectomy of the liver for gallbladder carcinoma. The patient subsequently presented 3 months later with isolated splenic metastasis and liver metastasis. Splenectomy and partial hepatectomy was performed at this time. Histological examination confirmed metastatic adenosquamous carcinoma of the gallbladder. No signs of recurrence were observed at 3 months after the second surgery.
  
  
  CONCLUSIONS
  Although splenectomy provides a potential means of radical treatment in patients with isolated splenic metastases, it should be performed with caution as splenic metastatic lesions may represent the initial clinical manifestation of systemic metastases at multiple sites. In this case, radical surgery was performed following the confirmation of no new unresectable metastatic lesions or systemic dissemination.
  
  
  CONCLUSIONS
  This is the first report on the adenosquamous splenic metastasis from the gallbladder carcinoma. Curative resection may be the treatment of choice for prolonging survival in patients with the splenic metastasis of gallbladder carcinoma.
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan. Electronic address: masashi11232001@yahoo.co.jp.
authors: Masashi
authors: M
authors: Utsumi
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Hideki
authors: H
authors: Aoki
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Tomoyoshi
authors: T
authors: Kunitomo
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Yutaka
authors: Y
authors: Mushiake
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Nobuhiko
authors: N
authors: Kanaya
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Isao
authors: I
authors: Yasuhara
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Takashi
authors: T
authors: Arata
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Kou
authors: K
authors: Katsuda
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Kohji
authors: K
authors: Tanakaya
authors: Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
authors: Hitoshi
authors: H
authors: Takeuchi
keywords: Adenosquamous carcinoma; Gallbladder carcinoma; Splenic metastasis