title: Meningeal carcinomatosis as the initial manifestation of a gallbladder adenocarcinoma associated with a Krukenberg tumor.
abstract: A case of malignant neoplasm is described in which the initial manifestations were mental dysfunction and meningeal irritation, mimicking chronic or subacute meningitis. Physical examination showed cranial nerve involvement and a pelvic tumor. There was progressive deterioration, and death occurred in 2 weeks. The autopsy revealed a gallbladder adenocarcinoma, meningeal carcinomatosis, and ovarian metastasis presenting as a Krukenberg tumor. The authors emphasize the importance of including meningeal carcinomatosis as a possibility in the differential diagnosis of non-characteristic clinical pictures, as well as the importance of the cerebrospinal fluid cytologic examination, repeated as needed, in order to confirm this diagnosis.
authors.affiliation: Departments of Pathology and Clinical Medicine, Infectious and Parasitic Disease Service, Antonio Pedro University Hospital, Faculty of Medicine, Fluminense Federal University, Rio de Janeiro, RJ, Brazil.
authors.forename: Tizuko
authors.initials: T
authors.lastname: Miyagui
authors.forename: Luciana
authors.initials: L
authors.lastname: Luchemback
authors.forename: Graça Helena Maia do Canto
authors.initials: GH
authors.lastname: Teixeira
authors.forename: Kátia Martins Lopes
authors.initials: KM
authors.lastname: de Azevedo
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D007725:Krukenberg Tumor / Q000556:secondary*; D008577:Meningeal Neoplasms / Q000556:secondary*; D010051:Ovarian Neoplasms / Q000556:secondary*