What question did this study set out to answer?

This study aims to evaluate the incidence and prognostic implications of splenic metastases in nonhematologic malignancies using FDG PET/CT.

April 7, 2026Cureus0 citationsOpen Access

Splenic Metastases: A Fluorine-18 Fluorodeoxyglucose PET/CT Analysis of Primary Tumor Distribution

AGAziz GültekinPamukkale University AÇAli ÇelikPamukkale University TŞTarık ŞengözPamukkale University

Key Points

This study aims to evaluate the incidence and prognostic implications of splenic metastases in nonhematologic malignancies using FDG PET/CT.
Retrospective cohort analysis of 10,295 PET/CT scans from January 2018 to December 2024
Identified 41 cases (0.40%) of splenic metastases via histopathology or imaging criteria
Measured maximum standardized uptake values (SUVmax) for splenic lesions
Performed multivariate analysis for survival factors
Mean SUVmax for splenic lesions was 8.39 ± 4.03
Common primary tumors included lung (34.15%), ovarian (21.95%), breast (9.76%), and colorectal (9.76%) cancers
Median overall survival after detection was 7.1 months
One-year survival rate was 31.7% and two-year rate was 28.2%
Patients with lung cancer had significantly poorer survival compared to others (HR = 2.43, p = 0.020)

Abstract

Background and aim Splenic metastases are uncommon and typically occur in advanced malignancies despite the spleen’s extensive vascular network. This retrospective, single-center cohort study aimed to provide an incidence-based evaluation of splenic metastases in a large PET/CT population and to assess their prognostic implications in contemporary clinical practice. Materials and methods Between January 2018 and December 2024, 41 cases (0.40%) of splenic metastases were identified among 10,295 patients with nonhematologic malignancies undergoing fluorodeoxyglucose (FDG) PET/CT. Metastases were verified through histopathology or, more commonly, through imaging-based criteria supported by longitudinal clinical and radiological follow-up, with consensus evaluation by two experienced nuclear medicine physicians. Maximum standardized uptake value (SUVmax) measurements were obtained for all splenic lesions. Results The mean SUVmax was 8.39 ± 4.03 (range: 3.89-22.22). The most common primary tumors were lung (34.15%), ovarian (21.95%), breast (9.76%), and colorectal (9.76%) cancers. All cases demonstrated concomitant metastatic involvement in other organs, with no isolated splenic metastases observed. Median overall survival was 7.1 months, with one-year and two-year survival rates of 31.7% and 28.2%, respectively. Patients with lung cancer showed significantly poorer overall survival compared to other primary tumors (HR = 2.43, 95% CI: 1.15-5.16, p = 0.020). In multivariate analysis, age and male sex were independently associated with overall survival. Conclusions Splenic metastases are rare (0.40%) in nonhematologic malignancies and are typically associated with widespread metastatic disease. The most common primary tumors are lung, ovarian, breast, and colorectal cancers. Survival is poor following splenic metastasis detection, with a median overall survival of 7.1 months. These findings provide valuable epidemiologic and prognostic data on splenic metastases detected by FDG PET/CT in clinical practice.

Demander à l'IA

Bookmark

View Full Paper