Infratemporal fossa and maxillary sinus metastases from colorectal cancer: a case report

Head and neck metastases from colorectal carcinoma are very rare. We report on a 47-year-old woman who had a vegetating tumor located at the distal sigmoid colon with initial liver metastases. She underwent palliative transverse colostomy to prevent intestinal obstruction. She was then treated with 5-fluorouracil, leucovorin and CPT-11. At the third cycle she presented with toothache and numbness of her upper lip. Computed tomography (CT) of the head and neck showed a gross mass involving the sphenoid sinus, left maxillary sinus, left pterygopalatine plate, pterygopalatine and infratemporal fossa. Histology of the mass revealed metastatic adenocarcinoma which was similar with the primary sigmoid carcinoma. The patient underwent radiotherapy and died 2 months later. Although cranial fossa metastases from colorectal cancer are very rare, the physicians should be aware of this type of metastatic pattern in patients who suffer of toothache, painful mastication or numbness of the lips, especially if decay has not been determined.