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Case report
Splenectomy for isolated splenic metastasis from primary lung adenocarcinoma
  1. Marc C Grant-Freemantle,
  2. Gary A Bass,
  3. Waqas T Butt and
  4. Amy E Gillis
  1. Department of General and Vascular Surgery, Tallaght Hospital, Dublin, Ireland
  1. Correspondence to Dr Marc C Grant-Freemantle; marcfreemantle{at}rcsi.ie

Abstract

A 73-year-old woman was referred to a tertiary centre with isolated splenic metastasis from previous pT1aNo stage 1a lung adenocarcinoma. The patient underwent a right lower lobe lobectomy and mediastinal lymph node dissection 2 years ago for invasive adenocarcinoma with no adjuvant therapy. An incidental finding of new splenic cyst was noted on surveillance imaging, which was fluorodeoxyglucose positive on positron emission tomography, and confirmed on cytology to be metastatic lung adenocarcinoma. After multi-disciplinary team’s review, the patient underwent splenectomy, with partial excision of diaphragm due to local infiltration. Her postoperative course was eventful, and was complicated by a simple fluid collection in the surgical bed (amylase negative), a left sided pneumonia and atelectasis and left sided pleural effusion, requiring antibiotics and radiological drainage of the abdominal and pleural collection. The patient recovered well and is currently doing well 9 months postoperatively with no evidence of recurrence or metastatic disease.

  • gastrointestinal surgery
  • general surgery
  • surgical oncology
  • lung cancer (oncology)
  • respiratory cancer
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Footnotes

  • Contributors MCG-F interviewed patient, acquired patient records and imaging and prepared the early draft of manuscript. GAB and WTB edited, fact checked, prepared later drafts of the manuscript. AEG as the senior author edited and approved the final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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