Metastases can spread to the Liver, causing pain, nausea, early satiety, and ultimately hepatic insufficiency Brain, causing behavioral changes, confusion, aphasia, seizures, paresis or paralysis, nausea and vomiting, and ultimately coma and death Bones, causing severe pain and pathologic fractures Adrenal glands, rarely causing adrenal insufficiency Paraneoplastic syndromes Paraneoplastic syndromes are symptoms that occur at sites distant from a tumor or its metastases.