title: Solitary splenic metastasis from nasopharyngeal carcinoma: a case report and systematic review of the literature.
abstract: BACKGROUND
  Solitary splenic metastases are a rare occurrence, and the nasopharyngeal carcinoma represents one of the most uncommon primary sources. The present study aimed to describe a rare case of a solitary single splenic metastasis from nasopharyngeal carcinoma and to assess the number of cases of isolated nasopharyngeal carcinoma metastases to the spleen reported in the literature.
  
  
  METHODS
  We describe the case of a 56-year-old man with a history of nasopharyngeal carcinoma and complete remission after chemo-radiotherapy. Three months after complete remission, positron emission tomography/computed tomography scan revealed a hypermetabolic splenic lesion without increased metabolic activity in other areas. After laparoscopic splenectomy, the pathology report confirmed a single splenic metastasis from undifferentiated carcinoma of the nasopharyngeal type. The postoperative period was uneventful. We also performed a systematic review of the literature using MEDLINE and Google Scholar databases. All articles reporting cases of splenic metastases from nasopharyngeal carcinoma, with or without histologic confirmation, were evaluated. The literature search yielded 15 relevant articles, which were very heterogeneous in their aims and methods and described only 25 cases of splenic metastases from nasopharyngeal carcinoma.
  
  
  CONCLUSIONS
  The present review shows that solitary splenic metastases from nasopharyngeal carcinoma are a rare event, but it should be considered in patients presenting with splenic lesions at imaging and a history of primary or recurrent nasopharyngeal carcinoma. No evidence supports a negative impact of splenectomy in patients with solitary splenic metastasis from nasopharyngeal carcinoma.
authors.affiliation: Department of General and Oncological Surgery, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, PA, Italy. pietro.genova@gmail.com.
authors.forename: Pietro
authors.initials: P
authors.lastname: Genova
authors.affiliation: Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Brunetti
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.|INSERM U955, Créteil, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bequignon
authors.affiliation: Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Filippo
authors.initials: F
authors.lastname: Landi
authors.affiliation: Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lizzi
authors.affiliation: Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Esposito
authors.affiliation: Department of Pathology, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Charpy
authors.affiliation: Department of Pathology, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Calderaro
authors.affiliation: Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
authors.affiliation: Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est - UPEC, Créteil, France.
authors.forename: Nicola
authors.initials: N
authors.lastname: de'Angelis
mesh_terms: D001706:Biopsy; D002277:Carcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D059248:Chemoradiotherapy; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D009305:Nasopharynx / Q000473:pathology; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D035583:Rare Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D013156:Splenectomy / Q000379:methods; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D016896:Treatment Outcome
keywords: Nasopharyngeal carcinoma; Splenic metastasis; Systematic review