title: [A case of intraventricular dissemination arising from hepatocelullar carcinoma effectively treated with intrathecal administration of methotrexate].
abstract: A 78-year-old man with hepatocellular carcinoma was admitted to our hospital for vertigo after transcatheter arterial chemoembolization. Contrast-enhanced magnetic resonance imaging revealed metastasis in the cerebellar vermis. Although the cerebellar metastasis decreased in size after cyberknife radiotherapy, multiple enhancing nodules appeared in the cerebral ventricles. A diagnosis of intraventricular dissemination from the cerebellar metastatic lesion originating from the hepatocellular carcinoma was made. Six intrathecal administrations of 20 mg of methotrexate through lumbar puncture resulted in a dramatic decrease in the intraventricular dissemination. Although intraventricular dissemination recurred 4 months later, these lesions disappeared after an additional 8 administrations of intrathecal methotrexate. Intraventricular dissemination arising from hepatocellular carcinoma is rare. Here we report a case that was successfully treated by intrathecal chemotherapy with methotrexate.
authors.affiliation: Department of Internal Medicine, Koseiren Namerikawa Hospital.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Oguri
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology*; D002551:Cerebral Ventricle Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D006801:Humans; D007278:Injections, Spinal; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate