Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

Figure 1 Imaging examinations of the colon. A: Initial contrast-enhanced computed tomography (CT) of abdomen showed slight enhancement of the wall of sigmoid colon and a mass (arrow); B: Positron emission tomography (PET)-CT showed a high metabolic shadow in the descending colon, suggesting metastasis, but no such shadow was seen in the spleen; C: PET-magnetic resonance imaging revealed a high metabolic shadow, suggesting metastasis.

Figure 2 The surgical specimen displayed multiple metastases (A-C).

Figure 3 The postoperative pathology (100 ×). A: Postoperative pathology with hematoxylin and eosin staining indicated multiple metastatic moderately differentiated adenocarcinoma of the spleen; B and C: Immunochemistry, cytokeratin 20 (+++), and caudal type homeobox 2 (+++) suggested metastatic adenocarcinoma.

Figure 4 Changes in carcinoembryonic antigen level in the reported patients. Three operations were performed as indicated by the arrows. CEA: Carcinoembryonic antigen.