Metástasis esplénica solitaria en una paciente con adenocarcinoma colorrectal / Splenic metastases secondary to colorrectal carcinoma

Introduction: Splenic metastases are unusual, arising in less than 1 percent of all metastases. Splenic metastases from colorrectal carcinoma is considered excepcional. If present, they generally occur in concert with disseminated disease. Case report: We present a case of 78 year old man operated of colon tumor by right hemicolectomy. Nine months after first surgical, CT scan showed metastases in spleen, splenectomy was performed.

Introducción: Las metástasis esplénicas son inusuales, representando menos del 1 por ciento de todas las metástasis. Que este tipo de localización secundaria sea ocasionado por carcinomas colorrectales puede considerarse como algo excepcional. Cuando se presentan generalmente lo hacen en el contexto de una enfermedad diseminada. Caso clínico: Presentamos el caso de un varón de 78 años de edad que fue intervenido de un carcinoma colorrectal mediante hemicolectomía derecha. nueve meses después de la primera cirugía el escáner muestra metástasis en el bazo, por lo que se realizó una esplenectomía.

Single nucleotide change in the cannabinoid receptor-1 (CNR1) gene in colorectal cancer outcome.

The cannabinoid receptor-1 (CNR-1) and endogenous agonists of this receptor are present in the central and peripheral nervous systems including the gastrointestinal nervous system. The surgically rejected specimens of human colorectal cancers and paired normal tissues were studied to detect mutations in the CNR1 gene by sequencing method. The results were compared to clinicopathological parameters and correlated with overall survival time. Sixty-three colorectal cancer patients, who underwent surgical excision of colorectal carcinoma, were included in this study. The coding region of the CNR1 gene was studied: a nucleotide change (G-->A) at position 1359 was identified by direct sequencing of PCR. Thirty-eight patients had the G/G genotype (wild type) in tumor areas and 25 patients had G/A heterozygous or A/A homozygous genotype. Univariate analysis revealed 2 independent variables associated with CNR1 gene mutation. The results show that the patients with Dukes stage C and D had a 2.9 times (p = 0.04) and patients that were lymph node positive had 2.8 times (p = 0.05) greater probability of nucleotide change in CNR1 gene. Genotype G/A plus A/A had a shorter overall survival time than G/G wild-type patients (p < 0.05). Indeed nontumor paired colorectal tissues showed nucleotide change. A large number of patients with mutation in the CNR1 gene were observed. These preliminary findings highlight the importance of further studies in the use of cannabinoid analogs as receptor ligands to analyze potential therapeutic effects.