Rectal Adenocarcinoma with Synchronous Brain Metastasis and Prolonged Overall Survival (OS)
A 61 years old woman with dizziness and gait disturbance in relation to brain metastases of a rectal adenocarcinoma (cT3N1M1). CT showed an unique frontal lesion and no further disease in other organs. Performance Status 1, so Digestive Tumors Committee decides surgical treatment of frontal brain metastasis and the histologic postsurgical examination showed microscopic affected margins. Then, radiation therapy (RT) of brain with radiosurgery and short course 5×5 of the primary tumor with low anterior resection was completed. After 2 months of brain RT, liver progression was discovered and then we decided neoadjuvant chemotherapy mFOLFOX6 and bevacizumab x 5 cycles with stable liver metastases and no other lesions. Following, limited liver resection and adjuvant chemotherapy was performed with the same schedule. No signs of tumor recurrence and more than 13 and 24 months of disease-free survival (DFS) and overall survival (OS) respectively was achieved in a metastasic cancer (brain metastasis) with usually OS 3 months.
