Survival from the precocious brain metastasis of the colon cancer

Abstract

Brain metastases frequently occur after the diagnosis of systemic cancer. However some patients with brain metastasis may be diagnosed before the primary tumor is found (precocious presentation). Colorectal cancer patients with brain metastasis have a poor prognosis due to the tendency of these patients to have a higher frequency of cerebellar metastases. Two different masses on the brain was found by MRI in a fifty-five year old man in January 1989. Pathologic examination revealed poorly differentiated adenocarcinoma. An extensive investigation failed to reveal the primary site. After 7 months, a mass in the caecum was found by colonoscopy. Complete surgical resection of the tumor and lymph nodes was performed. Pathologic specimen was reported as adenocarcinoma. In April 2002, 13 years after the diag-nosis of colon cancer, colonoscopy revealed an ulceroveg-etative mass in ascending colon and biopsy disclosed adenocarcinoma in low grade differentiation. This case is a survivor of inevitable death from the metastatic colon cancer and the second colonie malignancy has appeared 13 years later.