Isolated splenic metastasis from primary lung adenocarcinoma

Metastatic disease involving the spleen is uncommon, and isolated metastasis to the spleen is extremely rare. Most patients with splenic metastases have widely disseminated metastatic disease. A current literature review shows the incidence of isolated splenic metastasis ranges from 0 to 26% of all patients with splenic metastases. The reported primary malignancies of patients with splenic metastases include lung, colorectal, endometrial, ovarian, thyroid, pancreatic, gastric cancers, and, most commonly, melanoma. Although most patients with splenic metastases are clinically asymptomatic for splenic lesions, there have been reports of painful splenomegaly, splenic vein thrombosis, and splenic rupture, making diagnosis and consideration of prompt therapeutic intervention important. The time from diagnosis of a primary lung tumor to the discovery of splenic metastases ranges from 0 to 8 years in the literature. We report a rare case of an asymptomatic, isolated splenic metastasis in a 72-year-old man diagnosed 25 months after resection of an adenocarcinoma of the lung.