Iranian Journal of Nuclear Medicine

Iranian Journal of Nuclear Medicine

Isolated splenic metastasis: An uncommon manifestation of recurrent ovarian cancer

Articles in Press

Document Type : Case Report

Authors
Amin Saber Tanha 1
Haniye Elahifard 1
Mohsen Saberifar 2
Susan Shafiei 1
Ramin Sadeghi 1
1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran
10.22034/irjnm.2026.130538.1764
Abstract
Isolated metastasis to the splenic parenchyma from ovarian carcinoma is a rare finding and may go undetected on conventional imaging despite biochemical evidence of recurrence. We report a 58-year-old woman with rising tumor marker CA-125 and repeatedly negative anatomic imaging, in whom contrast-enhanced CT and [18F]FDG PET/CT finally identified a solitary hypermetabolic splenic lesion. A multidisciplinary review led to splenectomy, and histopathology confirmed metastatic ovarian carcinoma, followed by a marked decline in CA-125. This case highlights the diagnostic utility of [18F]FDG PET/CT in detecting isolated splenic metastases and its vital role in guiding potentially beneficial surgical management in patients with recurrent ovarian cancer.
Keywords
Genitourinary cancer
Gonadal cancer
Solitary metastasis
[18F]FDG
PET/CT
Subjects
  1. Wang X, Yang L, Wang Y. Meta-analysis of the diagnostic value of (18)F-FDG PET/CT in the recurrence of epithelial ovarian cancer. Front Oncol. 2022;12:1003465.
  2. Karni D, Kopelman D, Hatoum OA. Solitary splenic metastasis of ovarian carcinoma: a case report. J Med Case Rep. 2014;8(1):154.
  3. Ghani AA, Hashmi ZA, Chase DM, Patel SB, Jones DF. Intraparenchymal metastases to the spleen from ovarian cancer: a case report. J Med Case Rep. 2010;4(1):30.
  4. Olsen AB, Pargman S, Gillespie T. Solitary splenic metastasis from ovarian carcinosarcoma: a case report. J Med Case Rep. 2011;5(1):56.
  5. Hong Y, Peng J, Zeng Y, Deng X, Xu W, Wang J. The value of combined MRI, enhanced CT and (18)F-FDG PET/CT in the diagnosis of recurrence and metastasis after surgery for ovarian cancer. Clin Transl Oncol. 2024;26(12):3013–9.
  6. Soussan M, Pop G, Ouvrier M-J, Neuman A, Weinmann P. Diagnosis of synchronous isolated splenic metastasis from lung adenocarcinoma: complementary role of FDG PET/CT and diffusion-weighted MRI. Clin Nucl Med. 2011;36(8):707–9.
  7. Kim D-H, Jeong SY, Lee S-W, Lee J, Ahn B-C. Solitary splenic metastasis from hepatocellular carcinoma detected on 18F-FDG PET/CT. Clin Nucl Med. 2015;40(6):e325–7.
  8. Ji X, Dong A. FDG PET/CT in two patients with isolated splenic metastasis from colorectal cancer. Clin Nucl Med. 2025;50(11):1080-1082..
  9. Man X, Dong C, Dong A, Song X. FDG PET/CT in splenic metastasis from renal cell carcinoma. Clin Nucl Med. 2025 Dec 1;50(12):1209-1213.
  10. Xiao L, Li Y, Li L. Solitary splenic metastasis from endometrial carcinoma revealed on FDG PET/CT. Clin Nucl Med. 2022;47(12):e744–5.
  11. Xu T, Cen B, Liu L, Wang Y, Chen Y. 18F-FDG PET/CT findings of an isolated splenic metastasis from endometrial adenocarcinoma. Clin Nucl Med. 2020;45(12):1018–9.
  12. Dong A, Wang Y, Lu J, Zuo C. Enhanced CT and FDG PET/CT findings of splenic hamartoma. Clin Nucl Med. 2014;39(11):968–71.
  13. Lapa C, Steger U, Ritter CO, Wild V, Herrmann K. Differentiation of an unclear splenic lesion in a patient with cholangiocarcinoma. Clin Nucl Med. 2014;39(5):470–1.
  14. Choi AY, Wax BN, Yung E. Focal F-18 fluorodexyglucose positron emission tomography uptake in a hyalinized nodule as a false positive splenic metastasis in a patient with breast cancer and metastatic thyroid cancer. Clin Nucl Med. 2005;30(12):799–800.
  15. Lee DH, Yoon JK, Lee SJ, Jo KS, Yoon SH, An YS. Isolated splenic metastasis of ovarian cancer detected with 18F-FDG PET/CT. Clin Nucl Med. 2014;39(4):349–51.
  16. Lauro S, Trasatti L, Capalbo C, Conti A, Ricci F, Mingazzini PL, Vecchione A. Solitary splenic recurrence of epithelial ovarian cancer: a case report and review. Anticancer Res. 2002;22(6B):3643–5.
  17. Yasuda K, Yoshimura T, Kitade H, Yanagida H, Hosaka N. Laparoscopic splenectomy for solitary splenic metastasis in a patient with ovarian cancer with a long disease-free interval: a case report. J Med Case Rep. 2018;12(1):132.
  18. Yoshioka R, Okabayashi T, Nishimori I, Maeda N, Sugimoto T, Kohsaki T, Onishi S, Fukaya T, Kobayashi M, Hanazaki K. A long-survived case with solitary splenic metastasis from ovarian carcinoma. Surg Technol Int. 2008;17:192–4.
Iranian Journal of Nuclear Medicine

Articles in Press, Accepted Manuscript
Available Online from 08 August 2026