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CASE REPORT
Year : 2001  |  Volume : 17  |  Issue : 2  |  Page : 175-176
 

Early solitary splenic metastasis from adenocarcinoma of kidney


Department of Urology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
G Nabi
Senior Resident, Hostel 7, Room No. 49, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


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Keywords: Adenocarcinoma; Kidney; Spleen


How to cite this article:
Nabi G, Ansari M S, Seth A. Early solitary splenic metastasis from adenocarcinoma of kidney. Indian J Urol 2001;17:175-6

How to cite this URL:
Nabi G, Ansari M S, Seth A. Early solitary splenic metastasis from adenocarcinoma of kidney. Indian J Urol [serial online] 2001 [cited 2019 Jun 24];17:175-6. Available from: http://www.indianjurol.com/text.asp?2001/17/2/175/21057



   Case Report Top


A 50-year-old female presented with left flank pain of 2-months' duration. There was no other urinary complaint. General physical and systemic examinations were unre­markable. Urinary routine microscopy showed RBC 10­15/HPF with sterile culture after 48 hours. Haemogram and biochemical investigations were within normal lim­its. Ultrasonography revealed a solid mass in left kidney which was subsequently seen on contrast-enhanced com­puterised scan [Figure - 1]. Computerised scan also demon­strated a large solitary splenic solid mass [Figure - 1]. Her metastatic work-up which included chest X-ray, liver func­tion test and bone scan was normal. She underwent left radical nephrectomy with splenectomy and histopathol­ogy confirmed diagnosis of adenocarcinoma of kidney [Figure - 2] with solitary metastasis in spleen. She was dis­charged on 7 th postoperative day and is asymptornatic at a follow-up of 6 months.


   Comments Top


The commonest sites of metastases from adenocarcinoma of kidney are lungs, liver and lymph nodes. This is the sec­ond case of renal cell carcinoma with early solitary metasta­sis described in the English literature.' Metastatic carcinoma to spleen is a manifestation of widely spread disseminated disease. In an autopsy series of 7165 cases Berg et al found that 50% of all subjects who had five or more organs involved, had metastasis in spleen. [2] Most of the metastatic bur­den in spleen comes from melanoma, brochus, pancreas, breast, stomach and ovaries. [2] However, early spread to spleen without any evidence of spread anywhere else is a rare clini­cal event. [3] This is possibly because of rhythmic contractility, squeezing out tumour emboli, absence of afferent lymphatics and phagocytic activity. [4] A careful radiographic scrutiny of spleen should be done in all renal cell carcinomas as this site of metastatic disease is amenable to excision especially on left side with better survival. Because of rarity of this clinical event which was pre-operatively detected and successfully excised, case is reported.

 
   References Top

1.Berge T. Splenic metastasis: frequency and pattern. Acta Pathos Microbiol Scand 1974: 82: 499-506.  Back to cited text no. 1    
2.Naseem MS. Jan HA. Britton KE, Nargund VH. Splenic metastasis from adenocarcinoma of prostate. Br J Urol 1998: 82: 597-598.  Back to cited text no. 2    
3.Kishore PK, Guha D. Banerjee D. Early splenic metastasis in a case of renal adenocarcinoma. J Indian Med Assoc 1994: 276-277.   Back to cited text no. 3    
4.Knox LC. The relationship of massage to metastasis in malignant tumours. Ann Surg 1922: 175: 125-130.  Back to cited text no. 4    


    Figures

  [Figure - 1], [Figure - 2]



 

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