Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Mar 9;17(3):e80304.
doi: 10.7759/cureus.80304. eCollection 2025 Mar.

Metachronous Isolated Splenic Metastasis From Cervical Squamous Cell Carcinoma Directly Invading the Stomach: A Case Report

Charalampos Theocharopoulos  1 , Gabriela Stanc  2 , Charalampos-Christos Douligeris  1 , Elissaios A Kontis  1 , Nikolaos Kopanakis  1
Affiliations
Case Reports

Metachronous Isolated Splenic Metastasis From Cervical Squamous Cell Carcinoma Directly Invading the Stomach: A Case Report

Charalampos Theocharopoulos et al. Cureus. .

Abstract

The spleen is a very rare location for isolated blood-borne metastasis from squamous cell carcinoma of the uterine cervix (cSCC), thus splenic metastases from cSCC are associated with diagnostic and therapeutic challenges. We present a case of a 47-year-old woman with a history of International Federation of Gynecology and Obstetrics (FIGO) stage IIIc, human papillomavirus (HPV)-associated cSCC who presented with an isolated splenic metastasis eight months after completing primary treatment. The patient presented to the emergency department with symptomatic anemia. A CT scan of the abdomen showed a large splenic mass measuring 6.8 x 6.8 cm that appeared to directly invade the fundus of the stomach; a subsequent gastroscopy revealed an ulcerated, oozing lesion, which was biopsied and confirmed to be SCC. Following a multidisciplinary tumor board discussion, given the inability to obtain endoscopic hemostasis, the patient underwent expedited splenectomy, distal pancreatectomy, longitudinal gastrectomy, and pyloroplasty. Histological examination showed a high-grade, HPV-associated cSCC, consistent with metastatic spread from the known primary cervical cancer. The patient was initiated on cisplatin, paclitaxel, and pembrolizumab and received four cycles before experiencing disease progression.

Keywords: cervical cancer; oligometastatic cervical cancer; splenectomy; splenic metastases; squamous cell carcinoma.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Imaging and endoscopic findings.
A. Abdominal CT with IV and PO contrast shows a large splenic mass measuring 6.8 x 6.8 cm invading the gastric fundus. L: liver; S: spleen; Black arrow: stomach after oral contrast ingestion; White dashed arrow: splenic mass infiltrating the gastric fundus. B. Gastroscopy shows a slowly oozing, ulcerated lesion measuring 6 x 6 cm, representing full-thickness wall infiltration. M: splenic metastasis fully invading the gastric wall; G: normal gastric mucosa.
Figure 2
Figure 2. Surgical specimen.
En bloc surgical specimen of longitudinal gastrectomy and splenectomy; the pancreas is not visualized. S: spleen; G: stomach.
Figure 3
Figure 3. Histopathological findings.
A. H&E, x20: Poorly differentiated metastatic squamous cell carcinoma with pronounced nuclear atypia and central necrosis, infiltrating the stomach. B. H&E, x200. C. H&E, x40: SCC invading the spleen parenchyma. D. IHC, x40: Tumor cells positive for p40. E. IHC, x40: Tumor cells positive for p16. F. IHC, x200: Tumor cells positive for PD-L1, CPS > 1 (CPS = 15.5). IHC: Immunohistochemistry; SCC: Squamous Cell Carcinoma; CPS: Combined Positive Score; PD-L1: Programmed Death-Ligand 1.
See this image and copyright information in PMC

References

    1. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Singh D, Vignat J, Lorenzoni V, et al. Lancet Glob Health. 2023;11:0. - PMC - PubMed
    1. Cancer statistics, 2024. Siegel RL, Giaquinto AN, Jemal A. CA Cancer J Clin. 2024;74:12–49. - PubMed
    1. Carcinogenesis and management of human papillomavirus-associated cervical cancer. Kusakabe M, Taguchi A, Sone K, Mori M, Osuga Y. Int J Clin Oncol. 2023;28:965–974. - PMC - PubMed
    1. Patterns of metastases in cervical cancer: a population-based study. Zhou S, Peng F. https://pmc.ncbi.nlm.nih.gov/articles/PMC7414489/ Int J Clin Exp Pathol. 2020;13:1615–1623. - PMC - PubMed
    1. Splenic metastases--not a frequent problem, but an underestimate location of metastases: epidemiology and course. Sauer J, Sobolewski K, Dommisch K. J Cancer Res Clin Oncol. 2009;135:667–671. - PMC - PubMed

Publication types

LinkOut - more resources