A Case of Gastric Adenocarcinoma Presenting as Meningeal Carcinomatosis

Abstract

Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 49-year-old woman was admitted to our hospital with the symptoms of headache and melena for 10 days. The endoscopy showed a thickening of the folds of the stomach compatible with the diagnosis of a Borrman type IV gastric cancer. The biopsy revealed a signet ring cell carcinoma. The MRI of brain showed no abnormal findings; however, the patient complained of an intractable persistent headache, nausea and vomiting on admission day 6. The cytology examination of the cerebrospinal fluid supported the diagnosis of metastatic signet ring cell carcinoma.

Leptomeningeal Carcinomatosis Secondary to Gastroesophageal Adenocarcinoma: A Case Report and Literature Review of a Rare Occurrence

“…To our knowledge, there have only been two case reports of the management of LC from a gastroesophageal junction primary cancer [4,7] (Table 1). All three cases presented with histology of adenocarcinoma, and this was consistent with the most commonly reported histology in the literature [2,4,7]. Table 2 compares our case with the most common cerebral, cranial nerve, and spinal signs and symptoms of LC.…”

“…To date, only two cases have been described, the first was in 2001 and the other in 2003 [2,3]. LC has mostly been reported with breast cancer, prostate cancer, and melanoma [2][3][4][5]. We describe the third reported case of LC with brain involvement secondary to adenocarcinoma of the gastroesophageal (GE) junction ( Figure 1).…”

“…The occurrence of LC remains to be relatively uncommon; however, there is no precise published estimate of its incidence. It has, generally, been quoted as occurring in approximately 5% of cancer patients [2,3,5]. For patients with solid tumors, the incidence of LC can range from 4-15%.…”

“…LC caused by metastatic gastroesophageal adenocarcinoma has been rarely reported in the English literature. To date, only two cases have been described, the first was in 2001 and the other in 2003 [2,3]. LC has mostly been reported with breast cancer, prostate cancer, and melanoma [2][3][4][5].…”

Spinal Leptomeningeal Metastasis from Gastric Cancer: Case Report

“…En sık görülen semptomlar, baş ağrısı, bulantı, kusma, ilerleyici güçsüzlük ve işitme kaybıdır (5)(6)(7)(8). Hastamızda da benzer şekilde, şiddetli başağrısı, tüm vücutta ağrı ve şiddetli bulantı ve kusma şeklinde başlayan semptomlar, klinikte ense sertliğinin gelişimi, ilerleyici güçsüzlük ve sol hemiparezi, idrar-gaita inkontinansı şeklinde hızlı bir ilerleme göstermiştir.…”