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Had radical cystectomy. Enlarged internal iliac nodes, sequela of either infarct or possible mets, hypodense lession. Meaning?

My husband had a radical cystectomy in August - clear margins 28 nodes negative. CT two months post op in October showed two enlarged internal iliac nodes and his stage went from T3a to T4. In October, Spleen had hypodense lesion of 2.1 cm radiolostist impression was sequela of either infarct or possible mets.. Another CT with contrast done a month later showed an enlarged spleen with low density lesions inferiorly within the spleen. Two contiguous lesions with over all dimensions of 4.4 Cm Ap and 4.9 transverse. Spleen measures 14.3 cm in largest dimension. New CT done 2/13 shows hypodense lesion increased to 7.9 x 5.9 occupying entire inferior pole. Liver, gallbladder and pancreas are normal. My husbands been on intense chemo and his HGB has been very low 9.0 average. From what I ve read bladder cancer rarely mets to spleen. I want to consult with a specialist. Any suggestions?
Asked On : Sun, 17 Feb 2013
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Oncologist, Radiation 's  Response
What the information you have gathered is correct. Spleen mets is very uncommon and can almost be excluded as a possible diagnosis when liver shows almost normal study on imaging, please follow your doctors' advise. Adjuvant chemotherapy should be given , hope your husband will be free from disease very soon.
Answered: Sat, 23 Feb 2013
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