title: Chest wall pain as the presenting symptom of leptomeningeal carcinomatosis.
abstract: Leptomeningeal metastasis (LMM), also referred to as leptomeningeal carcinomatosis, results from diffuse infiltration of the leptomeninges by malignant cells originating from extra-meningeal primary tumors. It occurs in approximately 5%-10% of patients with solid tumor. Among solid tumors, the most common types leading to infiltration of the leptomeninges are breast cancer, lung cancer, and melanoma. Patients with LMM may present various signs and symptoms. Herein, we report a rare case with initial presentation of isolated chest wall pain. Computed tomography of the chest with contrast revealed a 2.5-cm nodule over the left upper lung. Biopsy confirmed the diagnosis of adenocarcinoma. Later, cerebrospinal fluid cytology exam also confirmed leptomeningeal seeding. It is rare for leptomeningeal carcinomatosis patients to present with chest wall pain. Therefore, a high index of suspicion is mandatory for accurate and prompt diagnosis.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Bo
authors.initials: KB
authors.lastname: Sim
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Ki Yeun
authors.initials: KY
authors.lastname: Nam
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Park
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Gi Hyeong
authors.initials: GH
authors.lastname: Ryu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Jihea
authors.initials: J
authors.lastname: Chang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Seoul, Korea.
authors.forename: Bum Sun
authors.initials: BS
authors.lastname: Kwon
keywords: Chest pain; Leptomeningeal metastasis; Lung cancer; Meningeal carcinomatosis; Neoplasm metastasis