Curative Intent Treatment for Colorectal Cancer with Isolated Brain Metastases: A Case Report

Cynthia Cherfane

doi:10.4172/2157-2518.s10-002

Abstract

Introduction: Brain metastases (BM) are a rare complication of colorectal cancer (CRC), typically presenting late in the course of the disease and are associated with other systemic metastases. Management of solitary brain metastases in colorectal cancer is still not well established. Case presentation: We describe the case of a 65 year-old man presenting with a solitary brain metastasis as the first sign of colon cancer. The treatment approach included surgical resection of the brain lesion followed by resection of the primary tumor, systemic chemotherapy and local radiation therapy to the BM. Conclusion: This curative intent approach has resulted in dramatically prolonged patient’s survival compared to the average reported in the literature, now nearly 2.5 years after presentation. Our case describes the feasibility of a multidisciplinary curative intent approach to solitary BM in CRC.

Highlights

Brain metastases (BM) are a rare complication of colorectal cancer (CRC), typically presenting late in the course of the disease and are associated with other systemic metastases
We report our experience with a patient who presented with a BM as the first sign of colon cancer
Management of liver and lung metastases with CRC is well established, with surgical resection for curative intent being the treatment of choice in selected patients with distant metastases and recurrences in whom the primary tumor is well controlled [10,11]

Summary

Conclusion

Significant progress has been made over the last two decades in management of patients with metastatic colon cancer, leading to curative treatment of patients previously resigned to palliative therapies. This has largely been restricted to patients with limited metastatic disease of the abdomen, liver or lungs, our case demonstrates that with some patients more aggressive therapy can be extended to include patients with brain metastases with excellent outcomes. Prospective studies are still needed to unify the management of BM in CRC patients, in patients with early and isolated BM, and well-controlled primary tumor site These studies will be limited by the small number of cases available. A copy of the written consent is available for review by the Editor-in-Chief of this journal

Introduction

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Discussion