Solitary intracranial metastatic adenocarcinoma of gastrointestinal origin

ABSTRACT

Seven cases of solitary intracranial metastatic adenocarcinomas of gastrointestinal origin are the subject of this study. They are a rarity and constitute around 2.7% of all brain metastases. Inspite of the thorough preoperative investigations to exclude and search for a primary, the brain lesion was the only known cancer in their bodies and the clue to the nature and origin of these secondaries. The affected elderly patients had a hurrican like course with signs of increased intracranial pressure. The neuroradiological imaging elicited a subcortical site of a single cystic mass within an edematous background. All the cases were operated upon achieving total excision with an excellent outcome in four cases and a good result in the remaining three patients. The histopathological examination revealed in five cases a mucinous adenocarcinoma of colonic origin. The other two cases proved to be poorly differentiated adenocarcinoma. Their primaries revealed themselves clinically in the colon and pancreas, only after the cranial surgery. All the patients had whole brain radiation postoperatively and remained clinically and radiologically, in the follow up period of 6 months, without local recurrence