title: Ten-Year Survival of a Patient Treated with Stereotactic Gamma Knife Radiosurgery for Brain Metastases from Colon Cancer with Ovarian and Lymph Node Metastases: A Case Report.
abstract: Brain metastasis from colorectal cancer is infrequent and carries a poor prognosis. Herein, we present a patient alive 10 years after the identification of a first brain metastasis from sigmoid colon cancer. A 39-year-old woman underwent sigmoidectomy for sigmoid colon cancer during an emergency operation for pelvic peritonitis. The pathological finding was moderately differentiated adenocarcinoma. Eleven months after the sigmoidectomy, a metastatic lesion was identified in the left ovary. Despite local radiotherapy followed by chemotherapy, the left ovarian lesion grew, so resection of the uterus and bilateral ovaries was performed. Adjuvant chemotherapy with tegafur-uracil (UFT)/calcium folinate (leucovorin, LV) was initiated. Seven months after resection of the ovarian lesion, brain metastases appeared in the bilateral frontal lobes and were treated with stereotactic Gamma Knife radiosurgery. Cervical and mediastinal lymph node metastases were also diagnosed, and irradiation of these lesions was performed. After radiotherapy, 10 courses of oxaliplatin and infused fluorouracil plus leucovorin (FOLFOX) were administered. During FOLFOX administration, recurrent left frontal lobe brain metastasis was diagnosed and treated with stereotactic Gamma Knife radiosurgery. In this case, the brain metastases were well treated with stereotactic Gamma Knife radiosurgery, and the systemic disease arising from sigmoid colon cancer has been kept under control with chemotherapies, surgical resection, and radiotherapy.
authors.affiliation: Department of Surgery, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Morinaga
authors.affiliation: Department of Surgery, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Naritaka
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Shitara
authors.affiliation: Department of Surgery, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishizaki
authors.affiliation: Department of Pathology, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Takatomo
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Neurosurgery, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kouga
authors.affiliation: Department of Neurosurgery, Fujioka General Hospital, Fujioka, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Wakabayashi
authors.affiliation: Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Moroyama, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.affiliation: Tsunoda Hospital, Tamamura, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tsunoda
authors.affiliation: Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
keywords: Brain metastasis; Colorectal cancer; Multidisciplinary therapy; Stereotactic Gamma Knife radiosurgery