Splenic metastases from colon carcinoma are rare. If present they generally occur in concert with disseminated disease. Six cases have been previously reported. The patient presented here is a 51-year-old black man who presented with an enterocutaneous fistula as a complication from prior pelvic radiation. Workup included an abdominal CT and needle biopsy, which confirmed the splenic metastasis from a sigmoid colon cancer 6 years after the original diagnosis. The patient had an unevenful splenectomy. Although no long-term follow-up data are as yet available splenectomy including removal of hilar lymph nodes appears to be the treatment of choice. A case report and review of the literature are presented.
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