从各种非血液系统恶性肿瘤转移到脾脏通常不是常见的临床事件,通常表明疾病的晚期传播。来自实体瘤的孤立性脾转移极为罕见。此外,原发性输卵管癌(PFTC)向脾脏的孤立性转移极为罕见,以前尚未报道。我们报告了一例60岁女性的孤立性脾转移,发生在全子宫切除术后13个月,双侧输卵管卵巢切除术,盆腔淋巴结清扫术,主动脉旁淋巴结清扫术,网膜切除术,并对PFTC行阑尾切除术。患者血清肿瘤标志物CA125升高至49.25U/ml(N<35.0U/ml)。腹部计算机断层扫描(CT)扫描显示脾脏中有4.0×3.0cm的低密度病变,可能是恶性的,无淋巴结肿大或远处转移。病人接受了腹腔镜探查,在脾脏中发现了一个病变。然后,腹腔镜脾切除术(LS)证实了PFTC的脾转移。组织病理学诊断显示,脾病变是PFTC转移的高分化浆液性癌。病人康复了一年多,没有肿瘤复发。这是第一例报道的从PFTC分离的脾转移病例。该病例强调了血清肿瘤标志物评估的重要性,医学影像检查,随访期间有恶性肿瘤病史,LS似乎是PFTC分离脾转移的最佳方法。
Metastases to the spleen from various non-hematologic malignancies are generally not a common clinical event and usually indicate the late dissemination of disease. Solitary splenic metastases from solid neoplasm are extremely uncommon. Furthermore, solitary metastasis to the spleen from primary fallopian tube carcinoma (PFTC) is extremely rare and has not been reported previously. We report a
case of isolated splenic metastasis in a 60-year-old woman, occurring 13 months after a total hysterectomy, a bilateral salpingo-oophorectomy, a pelvic lymphadenectomy, a para-aortic lymphadenectomy, an omentectomy, and an appendectomy were performed for PFTC. The patient\'s serum tumor marker CA125 was elevated to 49.25 U/ml (N < 35.0 U/ml). An abdominal computed tomography (CT) scan revealed a 4.0 × 3.0 cm low-density lesion in the spleen that was potentially malignant, with no lymphadenectasis or distant metastasis. The patient underwent a laparoscopic exploration, and one lesion was found in the spleen. Then, a laparoscopic splenectomy (LS) confirmed a splenic metastasis from PFTC. The histopathological diagnosis showed that the splenic lesion was a high-differentiated serous carcinoma from PFTC metastasis. The patient recovered for over 1 year, with no tumor recurrence. This is the first reported
case of an isolated splenic metastasis from PFTC. This
case underlines the importance of serum tumor marker assessment, medical imaging examination, and history of malignancy during follow-up, and LS seems to be the optimal approach for isolated splenic metastasis from PFTC.