Losing all sense: a case of meningeal carcinomatosis.
Meningeal carcinomatosis (MC) is diffuse infiltration of the meninges by metastatic carcinoma. Though a known complication of solid tumours, it is rarely seen as a presenting feature of such cancers. Here, the authors describe the case of a 64-year-old lady who presented with rapid-onset hearing loss and progressive visual loss, among other cranial nerve palsies. A primary non-small cell lung cancer was later identified by CT, but the diagnosis of MC was only confirmed after cytological analysis of a repeat lumbar puncture. Immunophenotyping of cells from the lung biopsy correlated with cells obtained from cerebrospinal fluid. In view of her rapid clinical deterioration, chemotherapy was not pursued, and the patient was transferred to a hospice 3 weeks after admission.
Department of Emergency Medicine, Chelsea and Westminster Hospital, London, UK. varo.kirthi@gmail.com
Varo
V
Kirthi
Henry
H
Penn
Shahir
S
Hamdulay
Amita
A
Ranger
Clare
C
Higgens
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D055756:Meningeal Carcinomatosis / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000556:secondary*; D008875:Middle Aged; D011859:Radiography; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*