Korean J Gastroenterol.  2025 Jan;85(1):89-92. 10.4166/kjg.2024.141.

A Case of Splenic Oligometastasis without Intrehepatic Recurrence Identified Six Years Following Hepatectomy for Hepatocellular Carcinoma

• Han JW
• Sung PS

• KMID: 2565021
• DOI: http://doi.org/10.4166/kjg.2024.141

Figure

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  Fig. 1 Radiologic findings. (A) 3-phase contrast-enhanced dynamic computed tomography shows hypoenhancing mass within the spleen. (B) T1-weighted 3-phase contrast-enhanced dynamic magnetic resonance imaging using Primovist® shows hypoenhancing mass within the spleen. (C) Diffusion-weighted imaging (DWI): Apparent Diffusion Coefficient (ADC) and high b-value (B800) images demonstrate the characteristic restricted diffusion of the splenic lesion.

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  Fig. 2 Positron emission tomography-computed tomography (PET-CT) findings. Fluorodeoxyglucose PET-CT scans showing high metabolic uptake in the spleen.

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  Fig. 3 Pathological and immunohistochemical findings. (A) Gross pathology of the spleen: The spleen exhibits nodular lesions with irregular borders, consistent with metastatic deposits. (B) Hematoxylin and Eosin (H&E) staining: Left—40× magnification shows tumor nodules infiltrating the splenic parenchyma. Right —400× magnification reveals characteristic trabecular architecture with malignant hepatocytes displaying nuclear pleomorphism. (C) Immunohistochemical staining: Positive α-fetoprotein (AFP, left) and Glypican-3 (right) staining confirm the diagnosis of metastatic hepatocellular carcinoma in the spleen.

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