Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 28, 2006; 12(40): 6561-6563
Published online Oct 28, 2006. doi: 10.3748/wjg.v12.i40.6561
Isolated splenic vein thrombosis secondary to splenic metastasis: A case report
Kunihiko Hiraiwa, Kyoei Morozumi, Hiroshi Miyazaki, Keiichi Sotome, Akio Furukawa, Makoto Nakamaru, Yoichi Tanaka, Hisami Iri
Kunihiko Hiraiwa, Department of Surgery, Hamamatsu Red Cross Hospital, Hamamatsu, Shizuoka, Japan
Kyoei Morozumi, Hiroshi Miyazaki, Keiichi Sotome, Akio Furukawa, Makoto Nakamaru, Department of Surgery, Fussa Hospital, Fussa, Tokyo, Japan
Yoichi Tanaka, Division of Surgical Pathology Clinical Laboratory, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan
Hisami Iri, Department of Pathology, Fussa Hospital, Fussa, Tokyo, Japan
Correspondence to: Kunihiko Hiraiwa, MD, Department of Surgery, Hamamatsu Red Cross Hospital, 1-5-30 Takabayashi, Hamamatsu, Shizuoka 430-0907, Japan. hiraiwa9215@hotmail.com
Telephone: +81-53-4721151 Fax: +81-53-4723751
Received: October 3, 2005
Revised: July 2, 2006
Accepted: August 21, 2006
Published online: October 28, 2006
Abstract

A 49-year-old, previously healthy woman sought treatment for abdominal pain. Colonoscopy revealed ascending colon cancer. Computed tomography and angiography showed splenic metastasis and thrombosis extending from the splenic vein to the portal vein. She underwent right hemicolectomy, splenectomy, and distal pancreatomy. Histological findings showed no malignant cell in the splenic vein which was filled with organizing thrombus. We postulate the mechanism of splenic vein thrombosis in our case to be secondary to the extrinsic compression of the splenic vein by the splenic metastasis or by the inflammatory process produced by the splenic metastasis. In conclusion, we suggest that splenic metastasis should be added to the list of differential diagnosis which causes splenic vein thrombosis. In the absence of other sites of neoplastic disease, splenectomy seems to be the preferred therapy because it can be performed with low morbidity and harbors the potential for long-term survival.

Keywords: Colon cancer; Splenic metastasis; Splenic vein occlusion; Splenic vein thrombosis