卵巣癌術後孤立性脾転移に対して腹腔鏡下脾部分切除を行った１例

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  • A Case of Solitary Splenic Metastasis from Ovarian Cancer Resected by Laparoscopic Partial Splenectomy

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We report a case of solitary splenic metastasis from ovarian cancer that was resected in laparoscopic partial splenectomy. A 65-year-old woman undergoing surgery to remove ovarian carcinoma (stage IIIc) and postoperative chemotherapy in June, 2002. In May, 2006, extremely high (108.6U/ml) of carbohydrate antigen 125 was found. Abdominal enhanced computed tomography showed a solitary tumor, 20mm in the spleen with enhanced high density. We suspected solitary splenic metastasis from the ovarian cancer and conducted partial splenectomy in laparoscopic surgery. The surgery took 146 mintes, and intraoperative blood loss was 30g. Macroscopically, the cut surface of the resected tumor showed a whitish-yellow solid pattern with a clearly 35×25×25mm border. It was diagnosed pathological by as metastatic poorly differentiated adenocarcinoma from ovarian cancer. The woman is doing well after surgery, being discharged on postoperative days 4 and undergoing adjuvant chemotherapy. We have found no recurrence in the 8 months since surgery. Solitary splenic metastasis is extremely rare and it has been reported that a good prognosis may be achieved by chemotherapy after splenectomy.

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