Background: The incidence of cervical cancer in Belgium is 11.1 per 100,000. With the introduction of cervical cytology screening and more recently anti-HPV vaccination, this rate has been decreasing for almost 20 yea...Background: The incidence of cervical cancer in Belgium is 11.1 per 100,000. With the introduction of cervical cytology screening and more recently anti-HPV vaccination, this rate has been decreasing for almost 20 years. Despite this, some patients are missed by the screening and prevention system and cervical cancer is still diagnosed at an advanced stage. Recurrences by splenic metastases are rare and are most often found at autopsy. Case Study: We describe the case of a 41-year-old caucasian patient with a single splenic recurrence after radiotherapy, chemotherapy, brachytherapy, and surgery for a poorly differentiated adenocarcinoma of the cervix grade 3 at an initial stage IIB according to FIGO. This recurrence happens 3 years after the initial treatment. After monitoring this asymptomatic lesion, the size increase results in laparoscopic splenectomy. Histology demonstrates a splenic metastasis recurrence of adenocarcinoma of endocervical origin. Conclusion: The spleen is a rare metastatic site in cervical cancer. Splenectomy followed by chemotherapy is the therapy most often found in the literature, which is however poor in this regard.展开更多
BACKGROUND Thymic carcinoma is a rare,aggressive tumor arising from the thymus.In less than 7%of patients with thymic carcinoma,extrathoracic metastases occur in the extrathoracic lymph nodes,liver,and bone.Isolated s...BACKGROUND Thymic carcinoma is a rare,aggressive tumor arising from the thymus.In less than 7%of patients with thymic carcinoma,extrathoracic metastases occur in the extrathoracic lymph nodes,liver,and bone.Isolated splenic metastasis can occur but is very uncommon.To date,only 2 cases of splenic metastases from thymic carcinoma have been reported.CASE SUMMARY A 45-year-old man presented with chronic cough,dyspnea,persistent hoarseness and unintentional weight loss 17 kgs in 6 mo.Neck magnetic resonance imaging revealed a large,lobulated,soft-tissue mass measuring 5.4 cm×6.6 cm×3.8 cm which involved the left superior mediastinum and supraclavicular fossa.Chest computed tomography(CT)revealed a confluent and lobulated soft tissue mass encased the right brachiocephalic artery,right and left carotid arteries,and left subclavian artery in the mediastinum.A fluorodeoxyglucose-positron emission tomography was arranged for malignancy survey.The image revealed intense fluorodeoxyglucose avidity in a soft tissue lobulated mass occupying the superior mediastinum,over the cystic lesion in the spleen and in few enlarged nodules over the left supraclavicular fossa.CT-guided biopsy of the thymic mass and the ultrasound-guided biopsy of the splenic lesion were consistent with a thymic carcinoma with splenic metastasis.The patient was diagnosed of thymic carcinoma,cT2N2M1b,stage IVb.CONCLUSION A fluorodeoxyglucose(FDG)-positron emission tomography(PET)scan can provide a useful diagnostic value in conjunction with pathological result in evaluating tumor staging.Our case emphasizes the utility of FDG-PET for metastasis detection in thymic carcinoma.展开更多
Gastrointestinal stromal tumor （GIST） represents the most common intramural mesenchymal tumor of the gastrointestinal tract, but the synchronous occurrence of GIST in the stomach and gynecological cancer is rare. We...Gastrointestinal stromal tumor （GIST） represents the most common intramural mesenchymal tumor of the gastrointestinal tract, but the synchronous occurrence of GIST in the stomach and gynecological cancer is rare. We present a unique case of a 56-year-old female patient who was diagnosed with the synchronous development of GIST and an isolated parenchymal splenic metastasis of ovarian cancer. She underwent a wide local excision of gastric lesions with splenectomy. A morphological （histological and immunohistochemical） study established a spindle-cell type of gastrointestinal tumor that expressed CDl17, and a parenchymal recurrence of ovarian papillary serous adenocarcinoma The patient has remained alive and disease-free for 30 months since the last operation. A small GIST concomitant with an isolated parenchymal splenic metastasis of ovarian cancer is rarely encountered. The coexistence of GIST with other malignancies constitutes an intriguing oncologic model. Surgeons are advised to be alert against possible primary GIST accompanying other neoplasms.展开更多
BACKGROUND Isolated splenic metastasis is a rare clinical entity.Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated metachrono...BACKGROUND Isolated splenic metastasis is a rare clinical entity.Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated metachronous splenic metastasis are exceedingly rare.CASE SUMMARY We report a colon cancer patient who underwent laparoscopic radical colon resection 14 mo previously,and subsequently underwent a second local resection due to local recurrence detected by elevated serum carcinoembryonic antigen(CEA)and positron emission tomography(PET).However,multiple metastases in the spleen were found 7 mo later by elevated serum CEA and PET-magnetic resonance imaging.Then the patient underwent total laparoscopic splenectomy.Local tumor recurrence and splenic metastasis from colorectal cancer(CRC)were found by postoperative pathology.Genetic analysis of these recurrent and metastatic tissues showed KRAS exon2,APC exon16 and TP53 exon6 missense mutations,but no mutations of NRAS,KRAF,EGFR,ERBB2,MET,MLH1,MSH2 and MSH6 were detected.Chemotherapy and target therapy were administered after multiple disciplinary team(MDT)consultation,and no tumor recurrence has been observed to date.We also reviewed the literature by conducting a search of the PubMed database using the following key words:CRC,splenic metastasis,isolated,and review.We identified 34 relevant papers,which included 28 cases of metachronous metastasis and 6 cases of simultaneous metastasis.CONCLUSION Close monitoring of serum CEA levels is crucial for the detection of isolated splenic metastases after colon surgery.In terms of overall survival and progression-free survival,MDT plays an important role in the entire process of disease management.展开更多
Globally,carcinoma of lung is the predominant cause of cancer death among both men and women.While hematogenous spread from primary lung cancer to multiple other organs is frequently reported,metastases of malignant t...Globally,carcinoma of lung is the predominant cause of cancer death among both men and women.While hematogenous spread from primary lung cancer to multiple other organs is frequently reported,metastases of malignant tumors to diaphragm and spleen are rare.Nowadays,Positron emission tomography(PET)with 18 F-fluorodeoxyglucose(FDG)has emerged in such a way that it has become an effective imaging technology for the evaluation of different carcinomas,particularly for cancer staging and follow up after therapy.PET scan is able to provide metabolic information.In this case,we present an attractive unified PET/CT scan image in a patient with lung carcinoma having unusual diaphragm and splenic metastases.So,PET/CT imaging could strongly identified rare and unusual metastatic sites of cancer and added more appropriate staging in patient with carcinoma of lung.展开更多
文摘Background: The incidence of cervical cancer in Belgium is 11.1 per 100,000. With the introduction of cervical cytology screening and more recently anti-HPV vaccination, this rate has been decreasing for almost 20 years. Despite this, some patients are missed by the screening and prevention system and cervical cancer is still diagnosed at an advanced stage. Recurrences by splenic metastases are rare and are most often found at autopsy. Case Study: We describe the case of a 41-year-old caucasian patient with a single splenic recurrence after radiotherapy, chemotherapy, brachytherapy, and surgery for a poorly differentiated adenocarcinoma of the cervix grade 3 at an initial stage IIB according to FIGO. This recurrence happens 3 years after the initial treatment. After monitoring this asymptomatic lesion, the size increase results in laparoscopic splenectomy. Histology demonstrates a splenic metastasis recurrence of adenocarcinoma of endocervical origin. Conclusion: The spleen is a rare metastatic site in cervical cancer. Splenectomy followed by chemotherapy is the therapy most often found in the literature, which is however poor in this regard.
文摘BACKGROUND Thymic carcinoma is a rare,aggressive tumor arising from the thymus.In less than 7%of patients with thymic carcinoma,extrathoracic metastases occur in the extrathoracic lymph nodes,liver,and bone.Isolated splenic metastasis can occur but is very uncommon.To date,only 2 cases of splenic metastases from thymic carcinoma have been reported.CASE SUMMARY A 45-year-old man presented with chronic cough,dyspnea,persistent hoarseness and unintentional weight loss 17 kgs in 6 mo.Neck magnetic resonance imaging revealed a large,lobulated,soft-tissue mass measuring 5.4 cm×6.6 cm×3.8 cm which involved the left superior mediastinum and supraclavicular fossa.Chest computed tomography(CT)revealed a confluent and lobulated soft tissue mass encased the right brachiocephalic artery,right and left carotid arteries,and left subclavian artery in the mediastinum.A fluorodeoxyglucose-positron emission tomography was arranged for malignancy survey.The image revealed intense fluorodeoxyglucose avidity in a soft tissue lobulated mass occupying the superior mediastinum,over the cystic lesion in the spleen and in few enlarged nodules over the left supraclavicular fossa.CT-guided biopsy of the thymic mass and the ultrasound-guided biopsy of the splenic lesion were consistent with a thymic carcinoma with splenic metastasis.The patient was diagnosed of thymic carcinoma,cT2N2M1b,stage IVb.CONCLUSION A fluorodeoxyglucose(FDG)-positron emission tomography(PET)scan can provide a useful diagnostic value in conjunction with pathological result in evaluating tumor staging.Our case emphasizes the utility of FDG-PET for metastasis detection in thymic carcinoma.
文摘Gastrointestinal stromal tumor （GIST） represents the most common intramural mesenchymal tumor of the gastrointestinal tract, but the synchronous occurrence of GIST in the stomach and gynecological cancer is rare. We present a unique case of a 56-year-old female patient who was diagnosed with the synchronous development of GIST and an isolated parenchymal splenic metastasis of ovarian cancer. She underwent a wide local excision of gastric lesions with splenectomy. A morphological （histological and immunohistochemical） study established a spindle-cell type of gastrointestinal tumor that expressed CDl17, and a parenchymal recurrence of ovarian papillary serous adenocarcinoma The patient has remained alive and disease-free for 30 months since the last operation. A small GIST concomitant with an isolated parenchymal splenic metastasis of ovarian cancer is rarely encountered. The coexistence of GIST with other malignancies constitutes an intriguing oncologic model. Surgeons are advised to be alert against possible primary GIST accompanying other neoplasms.
文摘BACKGROUND Isolated splenic metastasis is a rare clinical entity.Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated metachronous splenic metastasis are exceedingly rare.CASE SUMMARY We report a colon cancer patient who underwent laparoscopic radical colon resection 14 mo previously,and subsequently underwent a second local resection due to local recurrence detected by elevated serum carcinoembryonic antigen(CEA)and positron emission tomography(PET).However,multiple metastases in the spleen were found 7 mo later by elevated serum CEA and PET-magnetic resonance imaging.Then the patient underwent total laparoscopic splenectomy.Local tumor recurrence and splenic metastasis from colorectal cancer(CRC)were found by postoperative pathology.Genetic analysis of these recurrent and metastatic tissues showed KRAS exon2,APC exon16 and TP53 exon6 missense mutations,but no mutations of NRAS,KRAF,EGFR,ERBB2,MET,MLH1,MSH2 and MSH6 were detected.Chemotherapy and target therapy were administered after multiple disciplinary team(MDT)consultation,and no tumor recurrence has been observed to date.We also reviewed the literature by conducting a search of the PubMed database using the following key words:CRC,splenic metastasis,isolated,and review.We identified 34 relevant papers,which included 28 cases of metachronous metastasis and 6 cases of simultaneous metastasis.CONCLUSION Close monitoring of serum CEA levels is crucial for the detection of isolated splenic metastases after colon surgery.In terms of overall survival and progression-free survival,MDT plays an important role in the entire process of disease management.
文摘Globally,carcinoma of lung is the predominant cause of cancer death among both men and women.While hematogenous spread from primary lung cancer to multiple other organs is frequently reported,metastases of malignant tumors to diaphragm and spleen are rare.Nowadays,Positron emission tomography(PET)with 18 F-fluorodeoxyglucose(FDG)has emerged in such a way that it has become an effective imaging technology for the evaluation of different carcinomas,particularly for cancer staging and follow up after therapy.PET scan is able to provide metabolic information.In this case,we present an attractive unified PET/CT scan image in a patient with lung carcinoma having unusual diaphragm and splenic metastases.So,PET/CT imaging could strongly identified rare and unusual metastatic sites of cancer and added more appropriate staging in patient with carcinoma of lung.
