title: Dysphagia and anorexia as presentations of leptomeningeal carcinomatosis.
abstract: A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina. Cerebrospinal fluid analysis revealed carcinomatous cells. The patient was diagnosed as having leptomeningeal carcinomatosis secondary to lobular breast cancer and was started on radiation therapy, antihormonal treatments and intrathecal methotrexate.
authors.affiliation: Department of Psychiatry, Hofstra Northwell Health-Staten Island University Hospital, Staten Island, New York, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Aiyer
authors.affiliation: Department of Radiology, Harlem Hospital Center, New York, New York, USA.
authors.forename: Ester
authors.initials: E
authors.lastname: Engelman
authors.affiliation: Department of Pathology, Hofstra Northwell Health-Staten Island University Hospital, Staten Island, New York, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Xue
authors.affiliation: Department of Neurology, Hofstra Northwell Health-Staten Island University Hospital, Staten Island, New York, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Yu
mesh_terms: D000855:Anorexia / Q000175:diagnosis* / Q000209:etiology; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy; D003391:Cranial Nerves; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D055756:Meningeal Carcinomatosis / Q000150:complications / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D008875:Middle Aged; D013131:Spine