A colon cancer patient with splenic metastasis associated with a splenic abscess and thrombocytopenia: A case report

Rationale:Splenic metastases concomitant with abscesses are rare and challenging for clinicians. The primary treatment options include splenectomy and ultrasound-guided percutaneous perforation and drainage.Patient concerns:A case of splenic abscess in a colon cancer patient with splenic metastasis who developed chills and fever for approximately 2 weeks. However, the best broad-spectrum antibiotics are ineffective. Moreover, the patient had a high bleeding risk for percutaneous perforation due to a low platelet count.Diagnoses:Colon cancer, splenic metastasis, splenic abscess, thrombocytopenia.Interventions:Ultrasound-guided percutaneous splenic abscess perforation and drainage were performed after platelet transfusion and stimulation of platelet production in the bone marrow.Outcomes:His fever was immediately relieved at night and thrombocytopenia did not relapse thereafter. His platelet count increased rapidly and reached 121 x 109/L 3 days later.Lessons:Spleen metastasis in tumor patients necessitates vigilance for the potential development of spleen abscess. A less invasive procedure can be feasible in cases of low platelet count without significant coagulation dysfunction. When there is no alternative therapeutic schedule, doctors should fully evaluate the risks and benefits.