Splenic metastases
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Splenic metastases are relatively rare on imaging, although they are more commonly found on autopsy. Typically they are part of a widespread metastatic disease.
Epidemiology
The rate of splenic metastases varies between 1-10% of autopsy studies, depending on whether microscopic or macroscopic metastases were included 1.
Pathology
Most commonly metastases are a solitary splenic (solid or cystic) mass, may rarely be infiltrative 1,4. Primary sources include 1,2,5:
- cutaneous malignant melanoma (most common)
- breast cancer
- ovarian cancer
- colorectal cancer
- gastric cancer
- lung cancer
- clear cell renal carcinoma 6
- pancreatic neuroendocrine tumour 7
- thymic carcinoma 8
- prostatic adenocarcinoma 9
- oesophageal cancer 10
Radiographic features
Ultrasound
- solitary or multiple well-defined masses
- most commonly appear as a hypoechoic lesion (target appearance), although can be iso- or hyperechoic 3,5
- contrast-enhanced US (CEUS): rapid wash-in and wash-out 5
CT
- usually hypoattenuating masses
- cystic components may be present 5
MRI
- T1: low signal intensity
- T2: high signal intensity
- C+ (Gd): variable, mostly depending on the primary malignancy 5
-<a title="Clear cell renal carcinoma" href="/articles/clear-cell-renal-cell-carcinoma">clear cell renal carcinoma</a> <sup>6</sup>- +<a href="/articles/clear-cell-renal-cell-carcinoma">clear cell renal carcinoma</a> <sup>6</sup>
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