Splenic Rupture Due to Metastasis of Breast Cancer: A Report of a Rare Case and Focused Literature Review

TL;DR

A rare case of breast cancer metastasis to the spleen leading to rupture and death is reported, highlighting the need for vigilance in aggressive cancer cases.

Contribution

This paper presents a rare clinical case of splenic rupture due to breast cancer metastasis and emphasizes its clinical significance.

Findings

Breast cancer metastasis to the spleen is rare but can lead to life-threatening complications like splenic rupture.

The patient's aggressive tumor biology and multiple metastatic sites contributed to rapid disease progression.

Clinicians should be aware of the potential for splenic involvement in breast cancer with aggressive features.

Abstract

The most common primary tumors that metastasize to the spleen include melanoma, lung, colorectal, ovarian, and breast cancers (BC). Nearly all patients with splenic metastases (SM) present with disseminated malignant disease rather than isolated involvement. We report the case of a 58-year-old female patient with BC who developed SM and subsequently died following splenic capsular rupture. The patient initially presented with biopsy-proven BC and underwent neoadjuvant therapy followed by right modified radical mastectomy. She later received adjuvant systemic therapy, radiotherapy, and tamoxifen. During follow-up, cervical lymph node metastasis was detected, and breast magnetic resonance imaging (MRI) revealed a new lesion in the contralateral breast, metastatic left axillary lymph nodes, and multiple pulmonary nodules. She subsequently underwent a left modified radical mastectomy. A few days after this second surgery, she presented to the emergency department with acute symptoms. Imaging demonstrated a hepatic metastasis, a SM, and active splenic bleeding. Emergency splenectomy was performed; however, the patient died during postoperative observation. Although SM from BC is exceedingly rare, clinicians should remain alert, particularly in patients exhibiting aggressive tumor biology or unfavorable histological subtypes. Splenic involvement may progress rapidly and can lead to life-threatening complications, including capsular rupture.

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