title: Efficacy of Intrathecal MTX/Ara-C Combined with Systemic Chemotherapy in a Gastric Cancer Patient with Meningeal Carcinomatosis.
abstract: A 35-year-old man was diagnosed to have gastric cancer by endoscopic and histological examinations. Staging laparoscopy detected peritoneal metastasis. Systemic chemotherapy was started, but the patient complained of severe headache. Subsequently, a lumbar puncture demonstrated adenocarcinoma cells in the spinal fluid, suggesting the occurrence of meningeal carcinomatosis (MC) from gastric cancer. MC occurs only rarely in patients with gastric cancer, but the prognosis is invariably poor. However, this patient nevertheless survived for 12 months after receiving intrathecal MTX/Ara-C together with systemic chemotherapy. Therefore, the early detection of meningeal irritation sign and intrathecal chemotherapy might greatly improve the prognosis of gastric cancer patients with MC.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.forename: Hiroo
authors.initials: H
authors.lastname: Sei
authors.forename: Ken
authors.initials: K
authors.lastname: Hara
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Eda
authors.forename: Takashi
authors.initials: T
authors.lastname: Kondo
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Toyoshima
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kono
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Tozawa
authors.forename: Hisatomo
authors.initials: H
authors.lastname: Ikehara
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tomita
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oshima
authors.forename: Jiro
authors.initials: J
authors.lastname: Watari
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D017809:Fatal Outcome; D006261:Headache / Q000209:etiology; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D055756:Meningeal Carcinomatosis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008727:Methotrexate / Q000008:administration & dosage; D011379:Prognosis; D013129:Spinal Puncture / Q000379:methods; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
chemical_list: D003561:Cytarabine; D008727:Methotrexate