title: A case of leptomeningeal carcinomatosis from esophageal basaloid carcinoma diagnosed by quantitative reverse transcription-polymerase chain reaction for carcinoembryonic antigen.
abstract: We describe herein the case of a 68-year-old man who experienced leptomeningitis after esophagectomy from an esophageal basaloid carcinoma. Although the patient had a good operative course for the first 10 days after surgery, he suddenly had general convulsions with unconsciousness. He was placed on mechanical ventilation in an intensive care unit. Computed tomography and magnetic imaging resonance did not reveal any abnormal findings. No abnormal data in the cerebrospinal fluid were found by biochemical, virological, and cytological examination. The positive expression of carcinoembryonic antigen messenger ribonucleic acid in cerebrospinal fluid was detected by a quantitative reverse transcription-polymerase chain reaction method. Immunohistochemical staining using an anticytokeratin antibody confirmed the presence of tumor cells in the cerebrospinal fluid. Spontaneous breathing was recovered after treatment with systemic chemotherapy. Six months after surgery, computed tomography revealed multiple brain metastases. This case demonstrates that the quantitative reverse transcription-polymerase chain reaction method of analyzing carcinoembryonic antigen messenger ribonucleic acid may be a sensitive and useful method for determining leptomeningeal metastasis before the detection of tumors by cytological and imaging examinations in patients with cancer.
authors.affiliation: Department of Surgical Oncology, Digestive Surgery, Graduate School of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
authors.forename: Naoya
authors.initials: N
authors.lastname: Yokomakura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mataki
authors.forename: Yusei
authors.initials: Y
authors.lastname: Haraguchi
authors.forename: Hironori
authors.initials: H
authors.lastname: Sakita
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mihara
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Imamura
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kuratsu
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Sonshin
authors.initials: S
authors.lastname: Takao
authors.forename: Takashi
authors.initials: T
authors.lastname: Aikou
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D002277:Carcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary*; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary*; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger