Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis.

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Splenic metastases from solid tumors are uncommon but increasingly recognized due to advanced imaging and extended cancer patient follow-up.
• These metastases can manifest as part of widespread cancer or as isolated lesions within the spleen.

Purpose of the Study:

• To offer a comprehensive overview of the clinical and pathological characteristics of splenic metastases.
• To discuss the differential diagnosis and underlying pathogenesis of splenic metastases.

Main Methods:

• A literature review was conducted using PubMed.
• Search terms included 'metastasis' or 'metastases' combined with 'spleen'.

Main Results:

• Common primary cancers leading to splenic metastases include breast, lung, colorectal, and ovarian carcinomas, as well as melanoma.
• For solitary splenic lesions, colorectal and ovarian carcinomas are frequent origins.
• Less invasive diagnostic techniques like fine-needle aspiration or percutaneous biopsy are viable alternatives to splenectomy.

Conclusions:

• Differential diagnoses for splenic lesions include primary lymphoma, vascular tumors, and infectious etiologies.
• The spleen's unique microenvironment and anatomical factors may inhibit metastatic cell growth.
• Solitary splenic metastases might arise from dormant, early blood-borne micrometastases years after primary cancer diagnosis.