[A Case of Laparoscopic Distal Pancreatectomy and Partial Colectomy for Solitary Splenic Metastasis from Gastric Cancer].

The patient was a man in his 80s. Endoscopic examination revealed gastric cancer located on the anterior wall of the lesser curvature of the upper body of the stomach. He underwent laparoscopic proximal gastrectomy with D1+ lymph node dissection and esophagogastrostomy using the double-flap technique. The pathological staging was pT2N0M0, pStage ⅠB. He did not receive adjuvant chemotherapy. Eighteen months after surgery, follow-up non-contrast CT and PET-CT revealed solitary splenic metastasis. Due to his advanced age, chemotherapy was deemed difficult, and laparoscopic splenectomy was scheduled. Intraoperative findings revealed that the splenic metastasis had directly invaded the pancreas and colon, so laparoscopic distal pancreatectomy and partial colectomy were performed. Pathological examination confirmed recurrent solitary splenic metastasis from gastric cancer. Recurrence was detected in the greater curvature lymph node after 6 months postoperatively. The patient remains alive 7 months after surgery. Isolated splenic recurrence after gastrectomy for gastric cancer has been reported to achieve long-term survival with resection, and minimally invasive laparoscopic surgery may be considered as a treatment option for oligometastasis.