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Qi Cai and Peter Kragel
The prevalence of metastasis to the spleen is low in cancer patients. Splenic metastasis usually occurs only at the terminal stages of disease progression and is associated with multiple metastases in other sites. Only 19 cases of isolated splenic metastasis in patients with primary lung cancer have been reported in the literature. We report a case of isolated splenic metastasis in a patient with adenocarcinoma of the lung identified by CT scan and confirmed by pathologic examination and immunohistochemistry. Follow up positron emission tomography (PET) scan also identified sacral metastasis. The use of advanced imaging modalities such as PET scan may identify additional metastatic foci in patients who were previously considered to have isolated splenic metastasis.