title: [A case of meningeal carcinomatosis due to gastric cancer treated with intrathecal chemotherapy].
abstract: A 71-year-old man was admitted to our hospital in September 2009 because of severe headache due to meningeal carcinomatosis. In July 2007, subtotal gastrectomy was carried out for gastric cancer. Because intraabdominal cytodiagnosis was positive, he received systemic chemotherapy for 2 years. Recurrent signs were not found on chest or abdominal CT just before hospitalization. He was given NSAIDs and corticosteroid, but his symptom did not improve. Subsequent intrathecal chemotherapy with MTX and Ara-C improved clinical symptoms dramatically. He received care at home for 3 months before he passed away due to pleural and peritoneal recurrence. Recently, since the frequency of meningeal carcinomatosis is increasing, combination treatment of intrathecal chemotherapy and systemic chemotherapy should be considered not only for improvement of clinical manifestations, but also for prognostic improvement.
authors.affiliation: Department of Gastroenterology, Tachikawa General Hospital. ykoba-gi@umin.ac.jp
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Soichi
authors.initials: S
authors.lastname: Sugitani
authors.forename: Koshi
authors.initials: K
authors.lastname: Oseki
authors.forename: Takao
authors.initials: T
authors.lastname: Iiri
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D055756:Meningeal Carcinomatosis / Q000188:drug therapy* / Q000556:secondary; D008727:Methotrexate / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000473:pathology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D008727:Methotrexate