Unusual Metastatic Pathways: A Case of Colorectal Adenocarcinoma Presenting as a Cervical Neck Mass

Head and neck metastasis of colorectal adenocarcinoma is exceedingly rare with most cases presenting in the liver, lungs, or peritoneum. This report describes the case of a 53-year-old female patient with a past medical history significant for mucinous adenocarcinoma of the colon treated with a right hemicolectomy. She was thought to be in remission but presented a few years later with a new, isolated left cervical neck mass and symptoms of left eye ptosis and dryness. Diagnostic imaging and biopsy confirmed the neck mass to be a metastatic lesion from her prior mucinous adenocarcinoma, with immunohistochemical findings specific for colorectal origin. The case highlights the diagnostic challenges posed by such unusual metastatic sites and the importance of considering colorectal cancer in patients with a history of the disease who present with atypical symptoms. Early recognition of metastatic patterns, even in rare locations like the head and neck, is crucial for optimizing treatment strategies, which may include surgical resection, systemic chemotherapy, or targeted therapies. This report emphasizes the need for further research into the mechanisms of metastasis and the development of effective treatment protocols for rare metastatic presentations.