Metastatic Early-Onset Colon Cancer With BRCA2 Mutation Presenting With a Large Obstructing Pelvic Mass and Causing Acute Liver Failure and Acute Hypoxic Respiratory Failure

Colorectal cancer (CRC) still constitutes a significant healthcare burden. Although its overall incidence is reducing, the incidence of early-onset CRC is increasing. There is uncertainty about the association between CRC and BRCA2 mutations and also, even though most cancers metastasize to the liver, acute liver failure (ALF) from metastatic cancer and specifically CRC is uncommon. This is a case of a young patient with BRCA2 mutation who presented with a large obstructing CRC with extensive metastatic burden to the liver, causing a fatal ALF. This case shows the growing number of ALFs associated with metastatic disease and suggests a possible association between BRCA2 mutation and CRC. This association needs more research to establish.