Metastasis to the spleen from various neoplasms is very rare. Most of the splenic metastases are found at autopsy, and are part of a widespread disease. Four patients had cervical cancer (1 patient), endometrial cancer (1 patient), lung carcinoma (1 patient), and malignant melanoma (1 patient). All patients had splenic involvement without pathologic evidence of lymph node metastasis, and all underwent splenectomy. Three of the four presented with painful splenomegaly. The time from diagnosis to the develop ment of splenic metastasis varied from 20 to 24 months. Two of the four patients had postoperative radiotherapy, one patient received intraperitoneal chemotherapy, and the patient with the melanoma received adjuvant chemotherapy. The rarity of solitary spleen metastasis from solid tumors and the treatment modalities are discussed.
Cancer 6O:lOO-102, 1987.
ETASTASIS TO THE SPLEEN from various neo-M plasms is rare.' In autopsy studies, splenic metastases are found in approximately 7% of autopsied patients; breast cancer, lung cancer, and melanoma are the most common sources. Retroperitoneal tumors and pancreatic cancer may reach the spleen by direct extension. In contrast to the findings of splenic metastasis at autopsy, splenomegaly as the clinical manifestation of metastatic spread is extremely rare.4 In four patients, however, splenomegaly was the first clinical sign of metastatic disease.