Leonard J. Chabert Medical Center mississauga, ON, Canada
Nadish Ravindran, MD Leonard J. Chabert Medical Center, Houma, LA
Introduction: We present A rare case of primary cecal adenocarcinoma with metastasis to the brain. Furthermore, the brain metastasis was the initial finding, which in turn led to the diagnosis of colon cancer. This case portrays the relevance of understanding that although rare, colon cancer can metastasize to the unlikeliest of anatomical locations.
Case Description/Methods: A-42-year old white female with no significant past medical history and no family history of colon cancer presented to the emergency room after her husband noticed minor behavioral changes. He stated she had been losing her balance and had recently been involved in three minor car accidents, which was uncharacteristic of her. She reported experiencing fatigue, headaches, and nausea with weakness for the month prior to evaluation. Further detailed history taking revealed very few episodes of constipation and mild epigastric pain. She denied any changes in stool caliber, blood in her stool, melena or weight loss. Magnetic resonance imaging of the brain was performed and demonstrated a large frontal enhancing mass with significant surrounding edema. She underwent a craniotomy and pathology was suggestive of a primary gastrointestinal malignancy. Colonoscopy was performed and biopsy confirmed a well differentiated primary cecal adenocarcinoma. The patient was referred to Hematology/ Oncology for treatment options.
Discussion: Neurological symptoms do not usually allude to colon cancer and, although extremely rare, primary colon cancer with metastasis to the brain can be seen. This was a perplexing case, as the initial symptoms led to the diagnosis of brain metastasis, which in turn led to the diagnosis of primary cecal cancer. Despite exhibiting no gastrointestinal symptoms, the patient had widespread metastatic cancer affecting two diverse organs. Therefore, a multidisciplinary approach with the use of specialists for further analysis was utilized. In this case, Gastroenterology, Hematology/ Oncology and Neurology combined to successfully diagnose and treat the patient.
Disclosures:
Nadish Ravindran indicated no relevant financial relationships.
Nadish Ravindran, MD. E0139 - A Unique Case of Brain Metastasis Leading to the Diagnosis of Primary Cecal Adenocarcinoma, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.
