A rare case of metastasis of the spleen from recurrent cancer of the residual stomach

: In May, 1988, a 75-year-old housewife, who had undergone a subtotal gastrectomy for a carcinoma 12 years earlier, visited our hospital because of vomiting. Biopsy specimens of the residual gastric mucosa revealed malignant cells and an abdominal CT scanning examination showed a solitary nodule in the splenic parenchyma. A non-curative resection of the residual stomach, a splenectomy and a distal pancreatectomy were performed on June 3, 1988. Histological examination of the resected specimens demonstrated a moderately differentiated adenocarcinoma of the stomach, that had invaded the pancreas and retroperitoneal nodes. A nodule of the spleen that was inspected showed a round, greyish solid mass, 0.7 cm in diameter on the cut surface, and microscopically metastatic focus from a gastric cancer. Only a few operated cases manifesting a splenic metastasis of a gastric cancer have been reported and a definitive routing pattern of the metastasis is often difficult to distinguish. However, our case seems to suggest that a hemodynamic route had been taken, since there were no metastatic nodes around the splenic hilus and the metastatic site was only the parenchyma in the spleen.