Headache: Could it be Esophageal Cancer?

Brain metastasis in patients with primary esophageal carcinoma is rare and has a poor prognosis. Here we report a case with brain metastasis as the initial presentation for patient’s esophageal cancer. Case Presentation: A 59-year-old Caucasian female with history of diabetes mellitus type 2 and hypertension presented with worsening headaches and neck stiffness lasting 4 weeks. Soon thereafter, she developed imbalance and difficulty walking. A brain MRI was done and showed diffuse brain lesions with the largest being in the cerebellum. Patient was referred to our hospital and further investigations revealed that patient had primary esophageal adenocarcinoma. Discussion: Brain metastasis secondary to esophageal carcinoma is rare. In this patient, brain metastasis was the initial presentation from the underlying esophageal carcinoma.