Splenic Metastasis and Clinical Management
Summary
Splenic metastases are an uncommon manifestation of systemic malignancy, reported in fewer than 1 per cent of autopsy series. They most frequently arise from primary tumours of the breast, lung, colon, melanoma and ovary, yet the spleen’s unique immune microenvironment and anatomical blood flow appear to restrict secondary seeding. Patients are often asymptomatic and lesions are discovered incidentally during imaging or surveillance for raised carcinoembryonic antigen levels. Diagnosis rests on cross-sectional techniques such as contrast-enhanced computed tomography and positron emission tomography–computed tomography, supplemented by serum markers. Management requires a multidisciplinary approach: isolated splenic metastases may be managed curatively by splenectomy, preferably via minimally invasive techniques, whereas disseminated disease demands systemic therapy tailored to tumour histology. Surgical series indicate that complete resection of solitary lesions confers prolonged survival and symptomatic palliation. Advances in targeted agents and immunotherapy are reshaping adjuvant strategies, while refinements in imaging and liquid-biopsy platforms promise earlier detection. Global collaboration and registry data remain essential for standardising follow-up intervals, optimising therapeutic sequencing and refining prognostic models for this rare clinical entity.
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Splenic Metastasis and Clinical Management publication trend
The graph below shows the total number of articles in splenic metastasis and clinical management across all publications each year (not limited to Nature Index journals).
Technical terms
Metastasis: Secondary growth of malignant cells at a site distinct from the primary tumour, via lymphatic or haematogenous routes.
Splenectomy: Surgical excision of the spleen, indicated for therapeutic removal of isolated lesions or for palliation of symptomatic metastases.
Carcinoembryonic antigen (CEA): A glycoprotein tumour marker elevated in various adenocarcinomas, utilised for postoperative monitoring and recurrence detection.
Positron emission tomography–computed tomography (PET–CT): A hybrid imaging technique combining metabolic tracer uptake with anatomical detail to localise occult metastatic foci.
References
- Isolated splenic metastases from rectal carcinoma 5 years after surgery: Case report. Medicine (2023).
- Synchronous isolated splenic metastasis from cancer of hepatic flexure of colon. Medicine (2019).
- Splenectomy for solitary splenic metastasis of ovarian cancer. BMC Cancer (2004).
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