title: Carcinomatous meningitis from urachal carcinoma: the first reported case.
abstract: Carcinomatous meningitis (CM) occurs in less than 10% of cancer patients. Although patients frequently present with a focal complaint, multifocal signs are often found following careful neurological examination. The gold standard for diagnosis remains the demonstration of neoplastic cells in the cerebrospinal fluid. Despite the discouraging prognosis, palliative treatment may improve quality of life and lengthen lifespan. We report a patient with known primary carcinoma of the urachus who presented with headaches, nausea, vomiting and ataxia 1 week following resection of a nodular arachnoidal metastasis (indenting the cerebellum). Lumbar cerebrospinal fluid subsequently confirmed carcinomatous meningitis. This is the first reported case of carcinomatous meningitis resulting from metastatic urachal carcinoma.
authors.affiliation: Department of Neurological Surgery, Neurological Institute of New York, New York, NY 10032, USA.
authors.forename: Shearwood
authors.initials: S
authors.lastname: McClelland
authors.forename: Rebeca E
authors.initials: RE
authors.lastname: Garcia
authors.forename: Sara E
authors.initials: SE
authors.lastname: Monaco
authors.forename: James E
authors.initials: JE
authors.lastname: Goldman
authors.forename: Ty J
authors.initials: TJ
authors.lastname: Olson
authors.forename: Grace H
authors.initials: GH
authors.lastname: Kim
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Petrylak
authors.forename: Robert R
authors.initials: RR
authors.lastname: Goodman
mesh_terms: D000230:Adenocarcinoma / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000556:secondary; D000328:Adult; D002528:Cerebellar Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology / Q000556:secondary; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000556:secondary; D014057:Tomography, X-Ray Computed; D014497:Urachus; D014571:Urologic Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology*