Primary splenic malignant lymphoma mimicking metastasis of rectosigmoid cancer: A case report

Masaki Wakasugi; Yumiko Yasuhara; Yujiro Nakahara; Takashi Matsumoto; Hiroyoshi Takemoto; Ko Takachi; Kiyonori Nishioka; Kyotaro Yoshida; Satoshi Oshima

doi:10.1016/j.ijscr.2018.01.022

Primary splenic malignant lymphoma mimicking metastasis of rectosigmoid cancer: A case report

Int J Surg Case Rep. 2018:44:11-15. doi: 10.1016/j.ijscr.2018.01.022. Epub 2018 Feb 9.

Authors

Masaki Wakasugi¹, Yumiko Yasuhara², Yujiro Nakahara³, Takashi Matsumoto³, Hiroyoshi Takemoto³, Ko Takachi³, Kiyonori Nishioka³, Kyotaro Yoshida², Satoshi Oshima³

Affiliations

¹ Department of Surgery, Kinki Central Hospital, 3-1 Kurumaduka, Itami, Hyogo 664-8533, Japan. Electronic address: wakasugi_m@kich.itami.hyogo.jp.
² Department of Pathology, Kinki Central Hospital, 3-1 Kurumaduka, Itami, Hyogo 664-8533, Japan.
³ Department of Surgery, Kinki Central Hospital, 3-1 Kurumaduka, Itami, Hyogo 664-8533, Japan.

Abstract

Introduction: Primary splenic malignant lymphoma is quite a rare disease, and its preoperative diagnosis is difficult.

Case presentation: An 80-year-old man was diagnosed with advanced rectosigmoid cancer with liver and splenic metastases, for which he underwent single-incision laparoscopic high anterior resection for the primary rectosigmoid cancer. After chemotherapy, he underwent laparoscopy-assisted splenectomy and open partial hepatectomy of segment 3 and segment 5/6 of the liver. The resected specimen of the spleen showed primary splenic malignant lymphoma.

Discussion: A diagnosis of primary splenic malignant lymphoma seems to be made only occasionally at splenectomy. Patients with primary splenic malignant lymphoma treated by curative resection at an early clinical stage have a more favorable prognosis. Laparoscopy-assisted splenectomy is useful for reducing surgical invasiveness.

Conclusion: Primary splenic malignant lymphoma should be included among the differential diagnoses of splenic tumors in patients with colorectal cancer with multiple metastases. Curative resection might be a therapeutic option for the treatment of primary splenic malignant lymphoma. Laparoscopy-assisted splenectomy is a useful strategy for reducing surgical invasiveness.

Keywords: Colorectal cancer; Metastasis; Primary splenic malignant lymphoma.