title: [A Case of Isolated Leptomeningeal Carcinomatosis from Advanced Gastric Cancer].
abstract: Leptomeningeal carcinomatosis (LMC) is rare metastatic form of gastric cancer. Most cases are diagnosed in the final stage after multiple distant metastasis. An 84-year-old woman was admitted with melena, headache and vomiting. Esophagogastroduodenoscopy showed an ulceroinfiltrating lesion at the stomach (Borrmann class III), and biopsy revealed a signet ring cell carcinoma. The abdominal-pelvic CT showed no evidence of metastasis. A sudden decrease of consciousness was noted, but the brain CT showed no active lesion while the brain MRI revealed enhancement of leptomeninges. A lumbar puncture was performed and the cerebrospinal fluid study revealed malignant neoplastic cells. With family consent, no further evaluation and treatment were administered and she died six weeks after the diagnosis of gastric cancer. We report an extremely rare case of a patient who initially presented with neurologic symptoms, and was diagnosed LMC from advanced gastric cancer without any evidence of metastasis in abdomen and pelvis.
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Jung Geun
authors.initials: JG
authors.lastname: Ji
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Joo Won
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Nam
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Seung Kyu
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Dae In
authors.initials: DI
authors.lastname: Kim
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Byung Gwan
authors.initials: BG
authors.lastname: Jeon
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Yun Jae
authors.initials: YJ
authors.lastname: Shin
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000369:Aged, 80 and over; D001491:Basophils / Q000166:cytology; D001921:Brain / Q000000981:diagnostic imaging; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D055756:Meningeal Carcinomatosis / Q000175:diagnosis* / Q000556:secondary; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: Gastric cancer; Leptomeningeal carcinomatosis; Neurologic manifestations