What question did this study set out to answer?

To describe an unusual case of gastrointestinal adenocarcinoma with intracranial symptoms.

February 22, 2026

Atypical presentation of gastrointestinal adenocarcinoma: a rare and ominous intracranial presentation

Key Points

To describe an unusual case of gastrointestinal adenocarcinoma with intracranial symptoms.
Case presentation of a 64-year-old male with ataxia, headache, and dizziness.
Surgical gross total resection of cerebellar lesions was performed.
Histopathological assessment revealed papillary and micropapillary architecture.
Immunohistochemical tests were conducted to determine the origin of the lesions.
Histopathology confirmed metastatic adenocarcinoma.
Positive staining for CDX2 and CK7, negative for CD20 and TTF1.
NKX3.1 negativity excluded prostate origin, supporting the gastrointestinal source.
Patient referred for oncologic treatment based on findings.

Abstract

A 64-year-old male presented with several weeks of ataxia, headache and dizziness and was found to have multiple right cerebellar lesions. The remainder of staging imaging performed was unremarkable. He underwent gross total resection of the cerebellar lesions. Histopathology exhibited papillary and micropapillary architecture. Further immunohistochemistry showed CK7positive, CD20 negative and CDX2 positive staining. TTF1 negative excluded lung and thyroid carcinoma, meanwhile NKX3.1 negative excluded metastatic lesion originating from prostate. The results are consistent with metastatic adenocarcinoma, likely of upper gastrointestinal tract origin. He was subsequently referred for oncologic treatment.

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