Ileal metastasis of a Colorectal Carcinoma in an asymptomatic patient confirmed by Single-Balloon Enteroscopy

Malignant neoplasms of the small bowel are unusual and often constitute a diagnostic and therapeutic challenge. Metastatic small bowel lesions, which are extremely uncommon, usually arise from lung, breast or gastric cancer; metastases originating from a primary colon cancer are particularly rare (1). Involvement of the small bowel usually occurs due to local invasion or peritoneal dissemination, rarely emerging from a direct hematogenous route (1). Small intestine metastases are usually revealed through bowel obstruction or bleeding, being rarely asymptomatic; hence, diagnosis almost always occurs during surgical procedures in an emergency setting (2). In asymptomatic patients, whose lesions are identified preoperatively, the diagnosis can be particularly defiant.