Metachronous splenic metastasis from squamous cell carcinoma of the anus.

Abstract

A woman in her 70s with a history of metastatic squamous cell carcinoma (SCC) of the anus in systemic remission presented with a new splenic metastasis on surveillance CT imaging consistent with the primary site of the anus as confirmed by histology. The patient consented to surgical management via laparoscopic splenectomy, which was facilitated by a combination of laparoscopic and hand-assist ports. Mobilisation of the spleen revealed local tumour invasion into the diaphragm, requiring resection and resulting in capnothorax, which was appropriately repaired. Final pathology showed a well-circumscribed 7.9×6.8×5.2 cm mass exhibiting microscopic morphology and nuclear markers consistent with poorly-differentiated SCC of the anus, confirming metastatic disease. Splenic metastases are a rare finding that may require surgical management. Splenectomy can be feasibly managed using minimally invasive techniques, such as laparoscopy, with or without hand assistance.