Synchronous isolated splenic metastasis from cancer of hepatic flexure of colon: A case report

RATIONALE: Isolated splenic metastasis from colorectal cancer is very rare, as metastatic colorectal cancer involving the spleen is usually a manifestation of widely disseminated disease. Splenectomy is the best therapeutic option for this entity and probably the only chance for radical cure. PATIENT CONCERNS: A 73-year-old male presented with abdominal distension and dark red bloody stool of 6-month duration. DIAGNOSES: Synchronous isolated splenic metastasis from colorectal cancer. INTERVENTIONS: Based on multidisciplinary team (MDT) mode, the patient underwent the primary hepatic flexure tumor resection due to his poor general condition. One month after surgery the patient began treatment with Xelox (capecitabine 1000 mg/m(2), oxaliplatin 130 mg/m(2)) every 3 weeks. The patient underwent isolated splenic metastasis resection successfully by laparoscopic after four courses of chemotherapy. OUTCOMES: The patient's postoperative course was uneventful and he completed four courses of postoperative chemotherapy using the original chemotherapy regimen Xelox (capecitabine 1000 mg/m(2), oxaliplatin 130 mg/m(2)). The patient was subsequently followed up every 3 months and no signs of recurrence were noted in a recent examination. LESSONS: To the best of our knowledge, this is the first case report of isolated splenic metastasis from colorectal cancer in China. It is also the first case in which treatment was overseen by an MDT. The possibility of splenic metastasis should be considered in cases in which colorectal cancer is associated with a splenic lesion, despite its rarity. Splenectomy and adjuvant chemotherapy are the optimal therapeutic approaches, as such an approach prolongs survival and palliates the disease.