A 54-year-old man underwent abdominoperineal resection for carcinoma of the rectum. Three months later, neurologic signs and symptoms developed. A brain scan, as well as angiographic studies, demonstrated a space-occupying lesion in the right parietal area. A solitary tumor was removed at craniotomy. Histologic examination revealed a metastatic adenocarcinoma with a rectal primary tumor. For two years the patient remained well, but then signs of local perineal recurrence developed. Treatment with cobalt irradiation and chemotherapy was unsuccessful. Autopsy revealed local recurrence with numerous distant metastases; however, examination of the brain failed to show a recurrent metastatic focus.