Malar metastasis from rectal carcinoma: A case report

Facial metastasis from colorectal carcinoma is extremely rare. Only two cas es have been reported in the literature. This is the first reported case of malar metastasis from colon carcinoma. The patient was a 64-year-old, whit e woman who underwent a low anterior resection for a nearly obstructive car cinoma at 20 cm. Her chest X-ray revealed lung metastases, Postoperatively she was treated with fluorouracil and leucovorin. Twenty months later, she presented with left facial edema, which progressively increased in size. CT scan and magnetic resonance imaging with gadolinium showed a large soft ti ssue mass centered about the left anterior zygomatic arch. The platysma mus cle was displaced laterally, and the masseter muscle was involved. There wa s extension into the masticator space and bony involvement of the zygomatic arch. True-cut biopsy of the left cheek revealed metastatic adenocarcinoma . Histology was similar to that of the primary rectal adenocarcinoma. Metas tasis to the malar region is extremely rare. It is a grave prognostic sign, as it is associated with advanced terminal disease. Because of the widespr ead metastases, only palliative treatment can be provided.