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

Gilbert Georg Klamminger; Caroline Burgard; Florian Rosar; Katrin Altmeyer; Maciej Malinowski; Meletios P. Nigdelis; Phillip Rolf Stahl; Erich Franz Solomayer; Bashar Haj Hamoud

doi:10.12659/AJCR.941600

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 Klamminger^12ABCDEF*, Caroline Burgard^3BCD, Florian Rosar

^3BCD, Katrin Altmeyer

^4BCD, Maciej Malinowski^5BCD, Meletios P. Nigdelis

^1AEF, Phillip Rolf Stahl^2CD, Erich Franz Solomayer^1ABCD, Bashar Haj Hamoud^6ABCD

DOI: 10.12659/AJCR.941600

Am J Case Rep 2023; 24:e941600

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Table 1. Synopsis of published clinical cases of solitary splenic metastasis in patients with diagnosed primary carcinoma of the cervix uteri.

Author/Year of publication [ref]	Primary tumor entity/FIGO	Patient age	Metastatic symptoms	Diagnostics	Primary treatment	Secondary treatment of metastasis
Kumar et al [] (2022)¹²	SCC/ns	46	ns	PET scan, CT scan	Surgery, radiotherapy, chemotherapy	Surgery (splenectomy), adj. chemotherapy
AlQattan et al [] (2021)⁷	Adenocarcinoma/IIIB	54	ns	MRI	Radiotherapy, chemotherapy	Surgery (splenectomy), adj. chemotherapy
Liu et al [] (2021)¹³	SCC/IIB	49	Anorexia, abdominal distension	CT scan; carcinoembryonic antigen, CA125, CA199 antigen levels	Radiotherapy, chemotherapy	Surgery (splenectomy), adj. chemotherapy
Shankar et al [] (2020)¹⁴	SCC/IVA	55	ns	PET scan, CT-guided biopsy	Radiotherapy, chemotherapy	Surgery (splenectomy)
Filipescu et al [] (2018)¹⁵	SCC/ns	30	ns	ns	Neoadjuvant radiochemotherapy, surgery	Surgery (splenectomy)
Bacalbasa et al [] (2017)¹⁶	SCC/IIB	31	ns	Diagnostic surgery	Neoadjuvant chemotherapy & radiotherapy, surgery	Surgery (splenectomy), adj. chemotherapy
Applebaum et al [] (2017)¹⁷	SCC/ns	46	ns	PET scan, CT scan	Surgery, radiotherapy,	Surgery (splenectomy)
Dixit et al [] (2016)⁵	SCC/IIA	46	Fever and anorexia	PET scan, CT scan	Surgery, radiotherapy, chemotherapy	Surgery (splenectomy, segmental resection of ileum, omentectomy and partial peritonectomy), adj. chemotherapy
Villalón-López et al [] (2014)⁸	Adenocarcinoma/IB	76	Abdominal pain	CT scan, CA-125 antigen levels	Surgery, radiotherapy	Surgery (splenectomy), adj. chemotherapy
Taga et al [] (2014)⁴	Undifferentiated carcinoma/IIB	49	ns	CT scan, explorative laparotomy	Radiotherapy, chemotherapy	Surgery (splenectomy), adj. chemotherapy
Zamurovic et al [] (2011)¹⁸	Planocellular carcinoma/IB	40	Abdominal pain, rice water stools	Ultrasonography, CT scan	Surgery, radiotherapy	Surgery (splenectomy)
Di Donato et al [] (2010)¹⁹	SCC/IVA	30	Abdominal pain	CT scan, PET scan, SCC antigen levels	Neoadjuvant chemotherapy, surgery	Surgery (splenectomy, distal pancreatectomy, and partial gastric resection), adj. chemotherapy
Kim et al [] (2008)⁹	SCC/IIB	54	No abdominal discomfort/mass	SCC antigen levels, CT scan, PET scan	Radiotherapy, chemotherapy	Surgery (splenectomy), adj. chemotherapy
Kim et al [] (2008)⁹	Adenocarcinoma/IIB	46	No abdominal discomfort/mass	MRI	Radiotherapy, chemotherapy	Surgery (splenectomy), adj. chemotherapy
Bhardwaj et al [] (2008)²⁰	SCC/IIB	50	Painful abdominal mass, intermittent fever	Ultrasonography, explorative laparotomy	Radiotherapy	Surgery (splenectomy)
Komatsu et al [] (2004)²¹	SCC/ns	52	ns	CT scan	Surgery	Surgery (splenectomy)
Goktolga et al [] (2004)²²	SCC/IIA	45	Abdominal fullness and pain	CT scan and fine needle aspiration	Surgery and adjuvant radiotherapy	Explorative laparotomy; chemotherapy due to multifocal tumor invasion
Pang LC [] (2004)²³	SCC/IIA	50	ns	SCC antigen levels, CT scan, MRI, PET scan	Surgery and adjuvant radiotherapy	Surgery (splenectomy), adj. chemotherapy
Carvalho et al [] (1997)²⁴	SCC/IIB	47	Pain of regio hypochondriaca; weight loss	Explorative laparotomy	Radiotherapy	Chemotherapy
Valls et al [,] (1992)⁷	Adenocarcinoma/ns	55	Abdominal pain	CT scan	Surgery, radiotherapy	Surgery (splenectomy)
Campagnutta et al [] (1992)¹¹	Adenocarcinoma/ns	47	Abdominal pain	CT scan, scintigraphy	Surgery, radiotherapy	Surgery (splenectomy, adj. chemotherapy
Klein et al [,] (1987)³	SCC/IIB	28	Abdominal pain	CT scan	Radiotherapy	Surgery, chemotherapy
Brufman et al [,] (1977) ³	SCC/IB	43	ns	ns	Surgery	Chemotherapy
CT – computerized tomography; MRI – magnetic resonance imaging; ns – not specified; PET – positron emission tomography; SCC – squamous cell carcinoma. Additive splenic metastases as part of a disseminated disease were not considered. For an in-depth analysis of splenic metastasis in case if squamous cell carcinoma of the cervix uteri, see also the comprehensive overview of Marcu et al [] ^* Spanish article with English abstract available. ^ Japanese article with English abstract available. ^* Italian article with English abstract available. ^# Article in Hebrew.

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

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