Cranial
metastasis has been reported as infrequent during
colon cancers and usually occurs in the late stages with liver and/or lung
metastasis.
Metastasis to cavernous sinus is even rarer and only reported as case reports in the literature. In patients with cavernous sinus
metastasis, the most common primary sites are the breast, lung, and genitourinary
carcinomas, if head and neck
tumors are excluded. A 34-year-old man underwent a right
hemicolectomy for a
mucinous adenocarcinoma of the right colon 14 months before presentation. Because metastatic implants on the omentum were detected during the operation,
combination chemotherapy was begun. After 5 months of the last cycle of the
chemotherapy, his left eyelid began to droop, left eye movements became limited, and he began experiencing
numbness of his right forehead and cheek. Clinical and radiologic findings were discussed. Despite antiedematous treatment and
radiation therapy, he did not experience marked improvement of his symptoms. He could not be given
chemotherapy and died 2.5 months after the first symptom of cavernous sinus
metastasis. Primary
colon adenocarcinoma with cavernous sinus
metastasis is very rare. It was hypothesized that the paravertebral plexus of Batson could permit the spread of
tumor cells from pelvis toward the cranium. This could explain the
metastases from pelvis to the cavernous sinus, such as in our case. Prognosis for the patients with cavernous sinus
metastasis seems to be poor, and this might be the harbinger of rapid progression with widespread disease.