Unusual brain metastasis from colon cancer

Vargas-Urbina J.; Martinez-Silva R.; Rojas-Panta G.; Ponce-Manrique G.; Flores-Castillo J.; Anicama-Lima W. · Surgical Neurology International (2025) · DOI: 10.25259/sni_636_2024

Resumen

Background: Brain metastases due to colorectal cancer correspond to 3–5% of all brain metastases. The prognostic factors are based on age, functional status, and single metastasis. Its management is multidisciplinary, with poor prognosis despite the management. Case Description: A case of a 64-year-old male presented with symptoms of headache, disorientation, and nausea. The enhanced magnetic resonance image showed a mass in the right frontal horn of the lateral ventricle, contrast enhancing, with irregular borders, but defined, without restriction in diffusion-weighted images, associated with obstructive hydrocephalus. The investigations in search of a primary neoplasm were negative. A ventricular endoscopic approach was performed, with total resection of the lesion. Four months later, he developed a bowel obstruction with surgical management to control the primary, followed by chemotherapy and radiotherapy, with a current survival longer than 1 year. Conclusion: Brain metastases due to colorectal cancer are rare, and usually, when diagnosed, there are already pulmonary and hepatic metastases. Multidisciplinary management is recommended, where surgical management can be included in selected cases with controlled systemic disease, good functional condition, and single metastasis.