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RADIOLOGY: ABDOMEN: Case# 32838: SOLITARY SPLENIC METASTASIS, OVARIAN CARCINOMA. The patient is a 50 year old female with the history of melanoma discovered in 1994 on the left leg. She is found to have a solitary splenic mass and has undergone chemotherapy which was finished in November 1994. Comparison is made to a prior CT. The previously identified low density lesion in the spleen now measures 3.1x3.0cm. On the previous scan it measured 2.2x2.5cm. In addition, several low attenuation lesions up to 8mm in size can be identified in the anterior right and medial left lobes. These are present on images 8 and 15. They were not seen on the earlier study. Splenic metastases are a common cause of focal low density nodules in the spleen on CT. Malignant melanoma is a common cause of metastatic disease to the spleen, but metastases caused by breast, lung, and ovarian cancers are also seen. Typical CT features include one or more ill-defined nodules 10-20 H below the density of the surrounding spleen. Some form well-defined cystic nodules containing areas of necrosis and liquefaction which may have irregular-shaped regions within them that are even lower in density. Splenomegaly may or may not be present.

Peter Anderson