What happened, in summary

A 56-year-old woman was evaluated for a solitary mass in her spleen 6 years after treatment for ovarian cancer. Her original cancer had been a grade 3 endometrioid carcinoma of the right ovary, classified as Stage I. Initial treatment included hysterectomy with removal of both ovaries and fallopian tubes, followed by paclitaxel and carboplatin chemotherapy.

During long-term follow-up, her CA-125 level rose, prompting imaging. CT showed a 6 x 8 cm mass at the front of the spleen, with no other abdominal spread seen and a normal chest CT. She did not have symptoms from the splenic lesion. Surgery found no other abdominal disease, and splenectomy was performed. Pathology confirmed high-grade metastatic endometrioid carcinoma consistent with her previous ovarian cancer.

Her recovery from splenectomy was uncomplicated, and she returned to gynecologic oncology for another course of paclitaxel and carboplatin. The splenic recurrence represented distant spread of the ovarian cancer. Her case highlights a very late, isolated recurrence after an initially early-stage diagnosis, with treatment focused on removing the solitary metastasis and restarting systemic chemotherapy.