Solitary Parenchymal Splenic Recurrence of Ovarian Adenocarcinoma: A Case Report and Review of the Literature

Abstract

We report a rare case of solitary parenchymal splenic recurrence of epithelial ovarian cancer which developed 27 months after the initial treatment. The patient, a 53-year-old woman, with a history of breast cancer, underwent total abdominal hysterectomy bilateral salpingo-ophorectomy (TAH & BSO), omentectomy and pelvic lymph node sampling for a serous carcinoma of the ovaries (stage IIIB). She subsequently received 6 cycles of cisplatinum chemotherapy. During follow-up, rising CA 125 serum levels heralded the 6 x 6 cm parenchymal splenic lesion which was documented by CT scan. She underwent splenectomy after pneumococcal vaccination, sandostatin and chemoprophylaxis. Histopathological evaluation revealed metastatic parenchymal disease consistent with recurrent ovarian cancer. She remains alive and disease-free for 20 months since the last operation. Isolated parenchymal splenic lesions are very rare and may occur as a late recurrence in epithelial ovarian cancer. Splenectomy can be performed with acceptable morbidity and confers a substantial survival benefit to patients.