Case 2
A contrast-enhanced CT scan performed 6 months after the colon surgery showed a solitary splenic tumor (maximum diameter: 2.0 cm) without any other organ metastasis or dissemination. The tumor was homogenous and well-demarcated (Fig. 4a, b). Twelve months later, a follow-up contrast-enhanced CT scan showed marked enlargement of the splenic tumor (maximum diameter: 2.5 cm), without any other organ metastasis or dissemination (Fig. 4c, d). A laboratory workup demonstrated normal tumor marker levels (CEA: 5.2 ng/mL, CA19-9: <0.5 U/mL). We suspected metastatic cancer due to the rapid progression of the disease. Since the patient did not have any other organ metastasis, we performed laparoscopic splenectomy as a “diagnostic treatment” (Fig. 5).