Robotic Splenectomy for Isolated Splenic Recurrence of Endometrial Adenocarcinoma.
STUDY OBJECTIVE
To demonstrate management of a rare case of an isolated intraparenchymal splenic metastasis of endometrial cancer with robotic-assisted surgery.


DESIGN
Case report (Canadian Task Force Classification III).


SETTING
A 55-year-old patient with a history of endometrial cancer was found to have a splenic lesion on a follow-up examination. She underwent surgical staging, involving total hysterectomy, bilateral salpingo-oopherectomy, pelvic lymphadenectomy, and peritoneal washing, in 2014, and the final pathological findings showed an endometrioid endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics stage IB G2. Multidisciplinary counseling was provided, and the patient opted for strict medical surveillance. At 20 months after the primary treatment, the patient experienced a vaginal cuff recurrence and refused radiation therapy. She instead underwent robotic surgery, followed by 6 cycles of carboplatin 6 AUC and paclitaxel 175 mg/m2. Seventeen months later, a positron emission tomography/computed tomography scan revealed a 3-cm intraparenchymal lesion of the spleen, and robotic splenectomy was scheduled. The Institutional Review Board approved this study.


INTERVENTION
The operative time was 90 minutes, and blood loss was <50 mL. The operation was performed successfully, with no intraoperative and postoperative complications. Histopathological analysis showed a 3-cm intraparenchymal splenic lesion. The patient was discharged on day +2, and 46 days later started adjuvant chemotherapy based on carboplatin 6 AUC and doxorubicin (Caelyx) 30 mg/m2. At a 2-month follow-up, the patient was disease-free and in good general condition.


CONCLUSION
This case demonstrates the successful robotic management of recurrent endometrial cancer.
['Gallotta|Valerio|V|', "D'Indinosante|Marco|M|", 'Nero|Camilla|C|', 'Giudice|Maria Teresa|MT|', 'Conte|Carmine|C|', 'Lodoli|Claudio|C|', 'Zannoni|Gian Franco|GF|', 'Fagotti|Anna|A|', 'Scambia|Giovanni|G|']
D018269:Carcinoma, Endometrioid D016889:Endometrial Neoplasms D005260:Female D006801:Humans D007044:Hysterectomy D008197:Lymph Node Excision D008875:Middle Aged D009364:Neoplasm Recurrence, Local D065287:Robotic Surgical Procedures D013156:Splenectomy D013160:Splenic Neoplasms
Splenectomy Endometrial cancer Robotic surgery Endometrial recurrence