Isolated splenic metastasis in colorectal cancer - an example of the use of contrast ultrasonography (CEUS)
Abstract
Metastatic splenic involvement is relatively infrequent, overwhelmingly associated with extensive generalisation in other organs. The most commonly metastatic tumours to the spleen include colorectal cancer, carcinoma of lung, breast, ovary and malignant melanoma.
Solitary metastatic splenic involvement is rather rare. And thus the low frequency of these findings, a diagnosis by computed tomography may not always be clear, in which case a contrast enhanced ultrasonography of the spleen offers an additional imaging method.
CEUS of the spleen is a relatively simple and safe method that allows us to monitor in real time the vascularization of the lesion and surrounding parenchyma, and can thus often help distin-guish between benign or malignant lesions. The case shows an exaple of a patient after resection of rectal cancer with suspected solitary metastasis of the spleen.
It was the typical image on the contrast enhanced ultrasonography in this case that helped lead to the correct diagnosis, which was subsequently confirmed on the biopsy. The discussion outlines the possibilities of a contrast enhanced ultrasonography of the spleen and presents a differential diagnosis of a several most common benign and malignant spleen lesions.