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08 December 2023 : Case report  Germany

Unusual Case of Splenic Metastasis in Adenosquamous Carcinoma of the Cervix Uteri: Diagnosis and Treatment Considerations

Unusual clinical course

Gilbert Georg Klamminger12ABCDEF*, Caroline Burgard3BCD, Florian Rosar ORCID logo3BCD, Katrin Altmeyer ORCID logo4BCD, Maciej Malinowski5BCD, Meletios P. Nigdelis ORCID logo1AEF, Phillip Rolf Stahl2CD, Erich Franz Solomayer1ABCD, Bashar Haj Hamoud6ABCD

DOI: 10.12659/AJCR.941600

Am J Case Rep 2023; 24:e941600



BACKGROUND: Due to several factors such as its specific cellular and biochemical microenvironment, the spleen is not a predestined organ of frequent metastatic colonization in the case of primary solid carcinoma. Hence, the mode of diagnosis and the preferred treatment of a lesion highly suspicious of splenic metastasis must be decided on a case-by-case basis, considering not only the biological tumor entity but also the stage of the primary disease.

CASE REPORT: In the present case, we demonstrate the clinical course of a 37-year-old female patient who initially presented to our clinic with irregular vaginal bleeding. A consecutive gynecological examination revealed a 3×3-cm large mass of the cervix uteri, and the subsequent histomorphological workup led to the diagnosis of an adenosquamous carcinoma of the cervix uteri. Therapeutically, the patient received multimodal treatment, namely radical hysterectomy with adjuvant radio-chemotherapy. After 1.5 years, the patient presented to our Emergency Department with intermittent left-sided abdominal pain. Subsequent abdominal imaging (computed tomography scan, magnetic resonance imaging, positron emission tomography) determined a metabolically active splenic lesion with a central necrosis – signs of malignancy in line with a splenic metastasis. Presentation and discussion of the case within our interdisciplinary tumor board led to the decision of splenectomy followed by chemotherapy, a procedure that could be considered as therapeutic treatment in such exceptional cases.

CONCLUSIONS: The collection and reporting of atypical clinical courses remains a key factor in precision medicine to enable the most evidence-based decision making in such cases.

Keywords: Uterine Cervical Neoplasms, Spleen, Neoplasm Metastasis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923