title: Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report.
abstract: BACKGROUND
  Leptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of leptomeningeal metastasis from hepatocellular carcinoma.
  
  
  METHODS
  We herein report a case of leptomeningeal metastasis from hepatocellular carcinoma in a 53-year-old woman with concomitant systemic metastases to the lung, bone, brain, kidney, adrenal gland, subcutaneous tissues, and abdominal pelvis. The neurological symptoms of the patient were relieved after treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy.
  
  
  CONCLUSIONS
  To our knowledge this is the first report of leptomeningeal metastasis from hepatocellular carcinoma confirmed by cytology. Treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy was effective.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Pan
authors.forename: Guozi
authors.initials: G
authors.lastname: Yang
authors.forename: Tingting
authors.initials: T
authors.lastname: Yuan
authors.forename: Xiaochuan
authors.initials: X
authors.lastname: Pang
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Wang
authors.forename: Limei
authors.initials: L
authors.lastname: Qu
authors.affiliation: Department of Radiotherapy, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China. drlhdong@163.com.
authors.forename: Lihua
authors.initials: L
authors.lastname: Dong
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010841:Pia Mater / Q000473:pathology; D014057:Tomography, X-Ray Computed