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Case Report

Single brain metastasis from a minute, well differentiated, but invading beyond the tunica muscularis mucosa rectal carcinoid
We report the case of a 48-year-old woman with small-sized (who developed a solitary distant metastasis to the brain. The primary lesion, initially removed by conventional polypectomy, invaded the mucosa/tunica muscularis mucosa and had positive resection margins . Afterwards, an assessment of 5-hydroxyindoloacetic acid (5-HIAA) 24 h urine excretion revealed a significantly increased level. Thus, a partial rectal resection was performed. Because of constantly elevated carcinoid markers : serum chromogranin A (CGA) and 5-HIAA, a somatostatin receptor scintigraphy was performed , which disclosed a focus of pathological marker accumulation in the left frontal area. The pathological finding after neurosurgical excision was meningioma. An unexpected normalization of the biochemical markers prompted us to verify this diagnosis . The final histopathological report was a well-differen - tiated neuroendocrine brain metastasis. Our case shows that in well differentiated, of diameter

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