Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

26 April 2011

An unusual presentation of a newly diagnosed colorectal cancer with multiple brain and bone metastases without ct scan evidence of liver or pulmonary metastases

Ahmad F. Maatouk

DOI: 10.12659/AJCR.881748

Am J Case Rep 2011; 12:39-43

Abstract

Abstract
Background: Common sites of metastases from colorectal cancer include liver, peritoneum, and lungs. Brain and bone metastases occur infrequently. This report presents an unusual case of newly diagnosed Colon cancer with multiple brain and bone metastases with occult metastases to liver and lung only detected by using PET scan. Then we look over the possible hypothesis behind this enigma, trying to explain why our patient had brain and bone metastases in the absence of extra-cranial metastases on CT scan at the time of colon cancer diagnosis.
Case Report: A 59-year-old Caucasian female is presented with disorientation, headache and recurrent falls. She was recently diagnosed with Rheumatoid Arthritis and was started on Methotrexate. Brain imaging studies revealed multiple brain lesions. A CT scan of chest, abdomen and pelvis failed to show a primary origin. Blood tests detected iron deficiency anemia. And a colonoscopy found a colonic mass. Biopsies were positive for Adenocarcinoma.
PET scan demonstrated bone, lung, and hepatic metastases. Subsequently, patient underwent a transverse loop colostomy and partial omentectomy. She received whole brain radiotherapy, and she was scheduled to receive chemotherapy.
Conclusions: The systematic treatment of Rheumatoid arthritis with Methotrexate has partially suppressed the proliferation of extra-cranial and extra-ostial metastases to the extent they were not detected by CT imaging but only by PET scanning. And because Methotrexate could not cross the brain-blood barrier, the intracranial metastases manifested clinically before other metastases could cause any clinical symptoms or abnormal lab results.

Keywords: colon cancer, brain metastases, Iron deficiency anemia

0 Comments

SARS-CoV-2/COVID-19

22 February 2023 : Case report  Taiwan

A 30-Year-Old Woman with an 8-Week History of Anxiety, Depression, Insomnia, and Mild Cognitive Impairment ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938732  

22 February 2023 : Case report  Nigeria

Multidrug-Resistant Kocuria rosea and Methicillin-Resistant Staphylococcus aureus Co-Infection in a Nigeria...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938761  

In Press

17 Mar 2023 : Case report  USA

Dermoid Cyst of the Parotid Gland: Case Report of a Rare Entity and Review of the Literature

Am J Case Rep In Press; DOI: 10.12659/AJCR.939411  

17 Mar 2023 : Case report  Japan

A Case of a Refractory Bleeding Giant Vaginal Wall Cavernous Hemangioma Successfully Managed with Sclerothe...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939474  

16 Mar 2023 : Case report  Indonesia

Initial Thrombocyte Concentrate Transfusion in Woman with Chronic Immune Thrombocytopenia Purpura (ITP) Who...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938752  

15 Mar 2023 : Case report  USA

Thoracic Epidural as a Rescue Analgesic in a Patient with a Continuous Erector Spinae Plane Block for Rib F...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938875  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

07 Dec 2021 : Case report  USA

Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...

DOI :10.12659/AJCR.934347

Am J Case Rep 2021; 22:e934347

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923