First Department of Internal Medicine, Akita University School of Medicine
Splenic metastasis, HCC, Renal cell carcinoma, Gastric cancer
Three cases of splenic metastasis are described here. The first is from a hepatocellular carcinoma, the second is from a renal cell carcinoma, and the third is from a gastric carcinoma. Sonographic features of 50 previously reported cases of splenic metastasis are also presented. Splenic sonograms of the three cases were compared with their histological findings. A metastatic lesion from the hepatocellular carcinoma was imaged as an echogenic mass, and the entire tumor showed severe necrotic degeneration. Splenic metastasis from a renal cell carcinoma was observed as a round, isoechoic mass containing a central anechoic area. The isoechoic area was filled with clear cells, while the central anechoic area was caused by an intratumoral hemorrhage. A metastatic lesion from the gastric carcinoma was imaged as multiple, round masses of different echogenicity. Histology confirmed, as is observed in the first case, that the increase in echogenicity depended on the degree of intratumoral necrosis. Close attention must also be paid to the spleen when sonography is performed on cancer patients.