Abstract
This paper deals with a case of cecal cancer presented with neurologic symptoms due to synchronously occurred solitary brain metastasis, in which removal of the brain metastasis followed by resection of the primary lesion resulted in disease-free 15-month survival without chemotherapy. The case involved a 69-year-old woman who presented to the Department of Cerebral Surgery in our hospital because of memory deterioration starting in around August 2014 and the onset of dysphasia and decreased myodynamia at the beginning of September of the year. Following close exploration, brain metastasis of cecal cancer was diagnosed. Since her neurologic symptoms rapidly progressed, emergency craniotomy for enucleating the brain metastasis was performed 2 weeks after the onset of the symptoms. In addition, following stereotactic radiotherapy (SRT) for the tumor bed, we performed laparoscopic-assisted ileocecal excision with D3 lymph node dissection. The final diagnosis was C, type2, tub2 (>tub1), pT3, int, INFb, ly1, v2, pN0, pM1(brain) and fStage IV. The patient did not hope to receive adjuvant chemotherapy and we selected to follow her clinical course. Fortunately she has been free from neurologic symptoms and recurrence, as of 15 months after the initial treatment.
