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Case Report
A rare case of brain metastases from appendiceal carcinoma: A case report
1 Internal Medicine Resident, Internal Medicine Department, Englewood Hospital and Medical Center, Englewood, NJ, USA
2 Medical Student, Hackensack Meridian School of Medicine, Nutley, NJ, USA
3 Chief of Hematology/Oncology, Hematology/Oncology, Englewood Hospital and Medical Center, Englewood, NJ, USA
Address correspondence to:
Alyssa Foster
200 Sterling Blvd, Unit 2101, Englewood, NJ 07631,
USA
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Article ID: 100080Z10AF2021
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Foster A, Lofters J, Durham S, Jhawer M. A rare case of brain metastases from appendiceal carcinoma: A case report. J Case Rep Images Oncology 2021;7:100080Z10AF2021.ABSTRACT
Introduction: Primary appendiceal carcinoma is a rare form of gastrointestinal (GI) cancer, accounting for less than 1% of all GI tumors, with few cases involving metastatic disease. Here, we report a case, described infrequently in literature, of a brain mass found to be metastases from appendiceal carcinoma.
Case Report: We report the case of a 76-year-old male with a past medical history (PMH) of chronic lymphocytic leukemia (CLL) and appendiceal carcinoma who was transferred to our hospital after a witnessed seizure. Appendiceal carcinoma was previously diagnosed via colonoscopy for which he had surgical intervention and initially was managed expectantly. He was later noted to have an elevated carcinoembryonic antigen (CEA) with new soft tissue implants on computed tomography (CT). Omental biopsy confirmed presence of adenocarcinoma and systemic chemotherapy was initiated. The patient presented to an outside hospital where he had a pathologic fracture of the left humerus. On day of scheduled surgical repair he had a witnessed seizure. Magnetic resonance imaging (MRI) brain revealed a lesion in the left frontal lobe. The patient underwent craniotomy and resection of the lesion with final pathology revealing metastatic adenocarcinoma.
Conclusion: Although cerebral metastases are seen in approximately 5% of patients with GI cancers, local spread to peritoneal sites is more common. Distal spread is less likely to occur, documented in only 2% of appendiceal carcinoma cases. Due to this, there is no standard treatment regimen. It is important to recognize that although rare, appendiceal carcinoma does have the potential to metastasize to the brain and cause life-threatening sequelae.
Keywords: Appendiceal carcinoma, Brain metastases, GI malignancy, Seizure
SUPPORTING INFORMATION
Acknowledgments
Lopa Modi, MD (Pathology)
Mark Herman (Radiology)
Kevin Yao (Neurosurgery)
Alyssa Foster - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Jason Lofters - Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Samuel Durham - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Minaxi Jhawer - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Alyssa Foster et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
