title: Rapidly developing leptomeningeal carcinomatosis following anterior skull base surgery: a case report.
abstract: Leptomeningeal carcinomatosis is rare in evolution of head and neck cancers. Prognosis is poor and treatment is through supportive care. We report an atypical rapid post-operative leptomeningeal carcinomatosis after skull base resection for an ethmoidal adenocarcinoma. The anterior skull base resection was near-total and we suspect a seeding of subarachnoid space either before surgery, either during surgical extirpation or from the residual intracranial nodule. It is the first description of rapid LMC after surgery (less than 1 month). Post-operative MRI diagnosed the LMC through the detection of contrast enhancing leptomeningeal nodules at bilateral second and eighth cranial nerves and at bilateral interpedoncular area. A strong index of suspicion along with clinical and radiological correlation is essential to arrive at a correct diagnosis. Otolaryngologists should be aware of the possibility of leptomeningeal carcinomatosis, before or after surgery, in a patient presents with an appropriate constellation of neurologic symptoms and a history of cancer.
authors.affiliation: Department of Otorhinolaryngology and Head Neck Surgery, Gabriel Montpied Teaching Hospital Network, University of Clermont 1, rue Montalembert, F-63000 Clermont-Ferrand, France. jfvellin@chu-clermontferrand.fr
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Vellin
authors.forename: Viorel
authors.initials: V
authors.lastname: Achim
authors.forename: Denis
authors.initials: D
authors.lastname: Sinardet
authors.forename: Jean
authors.initials: J
authors.lastname: Gabrillargues
authors.forename: Thierry
authors.initials: T
authors.lastname: Mom
authors.forename: Laurent
authors.initials: L
authors.lastname: Gilain
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D000368:Aged; D035262:Cranial Fossa, Anterior / Q000473:pathology / Q000601:surgery*; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis / Q000556:secondary; D018450:Disease Progression; D005005:Ethmoid Sinus / Q000473:pathology / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000556:secondary*; D009366:Neoplasm Seeding; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000209:etiology; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed