卵巢恶性肿瘤脾转移12例临床分析

Intrasplenic metastasis of malignant ovariantumor: clinical analysis of 12 cases

我院自１９８６～１９９２年共诊断卵巢恶性肿瘤脾转移１２例，占同期收治卵巢恶性肿瘤的１．２％。其中，低分化者占５０％。通过影像学与手术进行诊断，发现脾转移距发现原发灶的中位发生时间为２８个月。形态特点为脾实质内单发或多发结节。临床表现无明显特异性。发生原因可能为肿瘤体积大、分化差、化疗致宿主免疫力低下等。脾转移多在肝转移之后或同时出现。转移途径可能以血行转移为主。单纯脾转移行手术切除，可望得到较好疗效。脾转移患者的预后差，死亡率高，中位生存时间为７个月。

ntrasplenic metastasis of ovarian malignancies areuncommon- From 1986 to 1992 only 12 such cases werediagnosed, being 1. 2/00 of the total number of patientswith ovarian malignancies treated in tumor hospital dur-ing the same period. Of the 12 metastasis, 6 were poor-ly differentiated. Diagnosis was made through iniagingtechniques or surgery.The median interval from the di-agnosis of the primary disease to intrasplenic involve-ment was 28 months. The metastatic Lesions, present-ed themselves as single or multiple nodes within the cor-tex of the spleen. Clinical features were not remarkable.It was thought that the occurrence of intrasplenic in-volvement might be due to greater tumor bulk, poor dif-ferentiation and decreased host immuno-competencecaused by chemotherapy. Most of the intrasplenicmetastasis was found after liver metastasis or simultane-ously with the latter. The main route of the tumorspread might be via blood vessels. Sole intrasplenicmetastasis can be treated by surgery with a temporarilygood result. Poor prognosis and high mortality charac-terize intrasplenic metastasis. Themedian survival wasonly 7 months.