We report a 50-year-old man with local recurrence of descending colon
cancer with
ileus obstruction and brain
metastasis, 2 years 6 months after initial resection due to perforation of descending colon
cancer(Hartmann procedure, D2 lymph node resection, Stage II, tub2). He complained of left upper
abdominal pain and abdominal fullness. He also complained of
paresis of the right upper extremity and of experiencing convulsions 1 month before admission. He was diagnosed with local recurrence of descending colon
cancer, based on findings of contrast radiography and the presence of colonic fiber. We subsequently performed transanal
decompression as a bridge to surgery and performed partial resection of the local recurrence in the anastomosis at the descending colon and ileum involved with the
cancer 2 weeks after
decompression. In addition, multiple lung and liver
metastases, and solitary brain
metastasis(2.5 cm in size located in the left side of the parietal region) were detected by cerebral plain computed tomography. However, he refused both
chemotherapy after surgery, as well as further surgery and/or
radiation therapy for the brain
metastasis. He desired to return to his home as soon as possible. In order to improve his quality of life(QOL), in-home treatment involving the best supportive care(BSC)conservative therapiesincluding,
anticonvulsant and anti-
intracranial hypertension drugs-were administered to prevent brain
metastasis symptoms, such as
paresis of the right upper extremities and convulsions. He was discharged from our hospital 14 days after surgery. Regrettably, he died due to
bronchial asthma 75 days after
palliative surgery in his home.