title: Leptomeningeal metastasis from occult signet-ring cell colon adenocarcinoma presenting with isolated headache.
abstract: We report a patient with a rare primary signet-ring cell carcinoma of the transverse colon with secondary leptomeningeal carcinomatosis. The only presenting and persistent symptom was worsening headache for 6 weeks until death. There were no other neurological, constitutional, or gastrointestinal symptoms. The primary tumor was detected by CT scan and confirmed by endoscopy, and the final diagnosis was eventually made from cerebrospinal fluid and tissue cytology. This report confirms the dismal prognosis of leptomeningeal carcinomatosis, especially when the primary malignancy is asymptomatic.
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232-2551, USA.
authors.forename: Kirk
authors.initials: K
authors.lastname: Kleinfeld
authors.forename: Walter Hamilton
authors.initials: WH
authors.lastname: Peters
authors.forename: Corinne
authors.initials: C
authors.lastname: Stephenson
authors.forename: Nabil J
authors.initials: NJ
authors.lastname: Azar
mesh_terms: D018279:Carcinoma, Signet Ring Cell / Q000473:pathology*; D003110:Colonic Neoplasms / Q000473:pathology*; D019723:Endoscopes; D006261:Headache / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed