[A Case of Isolated Splenic Metastasis after Colon Cancer Surgery]

A 74-year-old man underwent resection of descending colon cancer and was diagnosed with T4aN0M0, Stage Ⅱb. Isolated splenic metastasis was observed 6 months after radical colectomy. Tumor marker levels gradually increased despite chemotherapy with IRIS plus bevacizumab as first-line treatment and CAPOX plus bevacizumab as second-line treatment. A splenectomy was performed without metastasis. Histopathological examination demonstrated a moderately differentiated adenocarcinoma of the spleen that had metastasized from the colon cancer, and the histological response was Grade 1a. Although tumor marker levels markedly declined after splenectomy, multiple liver metastases were observed 6 months after surgery. Because splenic metastases are clinically rare and generally systemic, resectable splenic metastases are relatively uncommon. Resection for isolated splenic metastasis should be considered as a multidisciplinary treatment option, along with adjuvant chemotherapy and timing of surgery.