Cardiac metastasis and tumor embolism in a patient with adenocarcinoma of the colon presenting with paraneoplastic polymyositis

Colorectal cancer usually presents with alterations in the bowel habit. Less commonly, the presenting symptoms may be part of a paraneoplastic syndrome. Metastasis can occur by lymphatic or hematogenous spread, most frequently to the lungs and liver. We present the case of a 56-year-old man admitted with paraneoplastic polymyositis due to a poorly differentiated colon adenocarcinoma. The evolution was unfavorable with death on the 19th day following admission due to pulmonary thromboembolism and subsequent pulmonary edema. Autopsy showed micrometastases with lymphatic and venous emboli to the heart, liver, kidney, adrenal gland and lung. The case highlights the diversity of manifestation that can occur in a colon adenocarcinoma.