title: Leptomeningeal carcinomatosis from ethmoid sinus adenocarcinoma.
abstract: BACKGROUND
  Adenocarcinoma of the ethmoid is an aggressive tumor, with potential extension to surrounding structures. Leptomeningeal extension is a rarely reported entity.
  
  
  METHODS
  A carpenter, aged 55, developed multifocal cranial nerve-related symptoms 1 week after resection of adenocarcinoma of the ethmoid, evolving towards deteriorated general health status and death 10 weeks later. Brain MRI showed diffuse contrast enhancement of the cranial nerves, and repeated cerebrospinal fluid (CSF) examination found increased protein concentration associated with decreased glucose concentration, without malignant cells. The diagnosis of carcinomatous meningitis was based on the association of clinical, CSF and brain MRI data.
  
  
  CONCLUSIONS
  Leptomeningeal dissemination of adenocarcinoma of the ethmoid is rare; diagnosis is guided by clinical signs. MRI reveals neurological spread, but the presence of malignant cells in the CSF is sufficient for diagnosis. Due to poor prognosis, the only currently available treatments are palliative.
authors.affiliation: Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. Electronic address: florent.espitalier@chu-nantes.fr.
authors.forename: F
authors.initials: F
authors.lastname: Espitalier
authors.affiliation: Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.affiliation: Service de Radiologie, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: E
authors.initials: E
authors.lastname: Mourrain-Langlois
authors.affiliation: Service de Neurologie, Hôpital Nord-Laënnec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 01, France.
authors.forename: T
authors.initials: T
authors.lastname: Lebouvier
authors.affiliation: Service de Neurotraumatologie, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: E
authors.initials: E
authors.lastname: Bord
authors.affiliation: Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Ferron
authors.affiliation: Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: O
authors.initials: O
authors.lastname: Malard
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D005005:Ethmoid Sinus; D006801:Humans; D008297:Male; D055756:Meningeal Carcinomatosis / Q000175:diagnosis / Q000556:secondary*; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000473:pathology*