A case of gastric adenocarcinoma presenting as meningeal carcinomatosis.
Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 49-year-old woman was admitted to our hospital with the symptoms of headache and melena for 10 days. The endoscopy showed a thickening of the folds of the stomach compatible with the diagnosis of a Borrman type IV gastric cancer. The biopsy revealed a signet ring cell carcinoma. The MRI of brain showed no abnormal findings; however, the patient complained of an intractable persistent headache, nausea and vomiting on admission day 6. The cytology examination of the cerebrospinal fluid supported the diagnosis of metastatic signet ring cell carcinoma.
Lee
Hong Gi
HG
Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea. lhggi@yahoo.co.kr
Lee
Bora
B
Kim
Sang Min
SM
Suh
Byoung Jo
BJ
Yu
Hang Jong
HJ
D000305:Adrenal Cortex Hormones; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008353:Mannitol; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
D000305:Adrenal Cortex Hormones; D008353:Mannitol