Melanoma and isolated splenic metastases – case report and literature review
Abstract
Background. Metastases to the spleen are considered a rare event generally occurring during the late stage of malignant disease. Isolated metastases are even rarely described. In the past years the number of reported cases in literature has risen mainly due to the improvements of the imaging techniques and the use of FDG-PET/CT in the follow-up of the patients with malignant disease. Even though melanoma can disseminate to any organ, metastases to spleen, found during life, are rare. Moreover, proven isolated metastases in the spleen are even seldomly described.
Case report. We report a case of 61-year-old man with known skin melanoma treated in our Institute from 2009. During the regular follow up raised values of S-100 marker and isolated lesions in the spleen found on FDG-PET/CT were described. Due to isolated metastatic disease, splenectomy was indicated.
Conclusion. Patients with stage IV. melanoma have poor prognosis, the median survival is estimated to six months. According to studies, metastasectomies for isolated metastases in solid organs can significantly improve survival of these patients. In melanoma patients with FDG-PET/CT proven isolated metastases to the spleen, splenectomy can significantly improve their survival and quality of life.
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References
Schön CA, Görg C, Ramaswamy A, Barth PJ. Splenic metastatse in a large unselected autopsy series. Pathol Res Pract 2006; 202: 351-6.
Pallor K, Fernandes H, D'Souza CRS. Rare case of isolated splenic metastases from the breast. Basic and Applied Pathology 2012; 5: 76-8.
Hirst AE Jr, Bullock WK. Metastatic carcinoma of the spleen. Am J Med Sci 1952; 223: 414-7.
Berge T. Splenic metastases. Frequencies and patterns. Acta Pathol Microbiol Scand A 1974; 82: 499-506.
DeWilt JHW, McCarthy WH, Thompson JF. Surgical treatment of splenic metastases in patients with melanoma. J Am Coll Surg 2003; 197: 38-43.
Pugalenthi A, Bradley C, Gonen M, Gian K, Strong V, Jarnagin W, et al. Splenectomy to treat splenic lesions: an analysis of 148 cases at a cancer center. J Surg Oncol 2013; 208: 521-5.
Görg C, Hoffman A. Metastases to the spleen in 59 cancer patients: a 14-year clinicosonographic study. Ultraschall Med 2008; 29: 173-8.
Sen CA, Kargi A, Kaya V, Tanriverdi O. Isolated and solitary splenic metastasis detected by positron emission tomography in a patient with malignant melanoma: case report and review of the literature. Contemp Oncol (Pozn.) 2013; 17(2): 214-7.
Friedman KP, Wahl RL. Clinical use of positron emission tomography in the management of cutaneous melanoma. Semin Nucl Med 2004; 34: 242-53.
Belhocine TZ, Scott AM, Even-Sapir E, Urbain JL, Essner R. Role of nuclear medicine in the management of cutaneous malignant melanoma. J Nucl med 2006; 47: 957-67.
Ollila DW, Hsueh EC, Stern SL, Morton DL. Metastasectomy for recurrent stage IV melanoma. J Sug Oncol 1999; 71: 209-13.
Comperat E, Bardier-Dupas A, Camparo P, Capron F, Charlotte F. Splenic metastases. Clinicopathologic presentation, differential diagnosis and pathogenesis. Arch Pathol Lab Med 2007; 131: 965-9.
Metser U, Miller E, Kessler A, Lerman H, Lievshitz G, Oren R, et al. Solid splenic masses: evaluation with 18-FDG PET/CT. J Nucl Med 2005; 46(1): 52-59.
Buzbee TM, Legha SS. Spontaneous rupture of spleen in a patient with splenic metastases of melanoma. A case report. Tumori 1992; 78: 47-8.
Krapohl BD, Kömürcü F, Deutinger M. spleen rupture due to metastasis of thin melanoma (breslow thickness of 0,75 mm). Melanoma Res 2005; 15:135.
Klein B, Stein M, Kuten A, Steiner M, Barshalom D, Robinson E, et al. Splenomegaly and solitary spleen metastases in solid tumors. Cancer 1987; 60:100-2.
Karakousis CP, Elias EG. Spontaneous (pathologic) rupture of spleen in malignancies. Surgery 1974; 76: 674-7.
Tserkezoglou A, Kontou S, Hatjieleftheriou G, Nikolaidou ME, Planiotis G, Apostolikas N, et al. Solitary parenchymal splenic recurrence of ovarian adenocarcinoma: a case report and review of the literature. Anticancer Res 2005; 25: 1471-6.
Trindade MRM, Blaya r, Trindade EN. Melanoma metastasis to the spleen: Laparoscopic approach. J Minim Access Surg 2009; 5(1): 17-9.
Chua TC, Saxena A, Morris DL. Surgical metastasectomy in AJCC stage IV M1c melanoma patients with gastrointestinal and liver metastases. Ann Acad Med Singapore 2010; 39: 634-9.
Leo F, Cagini L, Rocmans P, Cappello M, Geel AN, Maggi G, et al. Lung metastases from melanoma: When is surgical treatment warranted? Br J Cancer 2000; 83: 569-72.
Wood TF, DiFronzo LA, Rose DM, Haigh PI, Stern SL, Wanek L, et al. Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival? Ann Surg Oncol 2001; 8: 658-62.
Harpole DH Jr, Johnson CM, Wolfe WG, George SL, Seigler HF. Analysis of 945 cases of pulmonary metastatic melanoma. J Thorac Cardiovasc Surg 1992; 103: 743-8.
Khadra MH, Thompson JF, Milton GW, McCarthy WH. The justification for surgical treatment of metastatic melanoma of the gastrointestinal tract. Surg Gynecol Obstet 1990; 171: 413-6.
Haigh PI, Essner R, Wardlaw JC , Stern SL, Morton DL. Long-term survival after complete resection of melanoma metastatic to the adrenal gland. Ann Surg Oncol 1999; 6: 633-9.
Sauer J, Sobolewski K, Dommisch K. Splenic metastases-not a frequent problem, but an underestimate location of metastases: epidemiology and course. J Cancer Res Clin Oncol 2009; 135: 667-71.
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