A case of metastatic leptomeningeal carcinomatosis from early gastric carcinoma

Abstract

Metastatic leptomeningeal carcinomatosis is estimated to occur in 3% to 8% of solid carcinomas. The most common causes of leptomeningeal carcinomatosis are breast cancer, lung cancer and malignant melanoma. Leptomeningeal carcinomatosis associated with gastric cancer, especially in its early stages, is exceedingly rare. Its presenting symptoms include headache, nauseaand seizures. In this report, we describe a case of leptomeningeal metastasis that presented with early-stage gastric cancer. A 67-year-old woman with a history of early-stage gastric cancer in remission was admitted to our hospital with 3 days of headache and nausea. Her gastric cancer had been treated 29 months prior to presentation by a radical subtotal gastrectomy with a Billroth I anastomosis. She had an uneventful recovery until she was diagnosed with metastases to the left axilla and neck 26 months after surgery. Her presenting symptoms of headache and nausea prompted cytologic examination of the cerebrospinal fluid and measurement of tumor markers, which revealed metastatic leptomeningeal carcinomatosis from her gastric cancer. This report aims to raise awareness of the possibility that even early-stage gastric cancer can lead to leptomeningeal carcinomatosis.

Gastric Metastasis of Breast Cancer: A Case Series

“…The most common causes of leptomeningeal carcinomatosis are breast cancer, lung cancer and malignant melanoma. 10 In our series, three patients had meningeal infiltration, so we hypothesized that there could be some similarity between meningeal and gastric tumor microenvironment favorable to tumor cell implantation…”

Ophthalmoplegia in a Her2+ and β-hCG+ Patient With Leptomeningeal Carcinomatosis Secondary to Gastric Adenocarcinoma

“…LMC secondary to gastric cancer is rarer, with only 0.14%-0.24% of gastric cancer resulting in leptomeningeal infiltration [1,7]. It is most often associated with poorly differentiated adenocarcinoma with signet ring cell features [8], with studies suggesting that the predominant route taken by tumor cells is the Batson's venous plexus to spread into the subarachnoid space [5]. LMC mostly affects the CNS and presents most frequently with headache, followed by visual loss [1].…”

Leptomeningeal carcinomatosis from gastric cancer successfully treated by the intrathecal methotrexate plus temozolomide and simultaneous radiotherapy: Case report and literatures review

“…In the reported literature, the sensitivity of cranial MRI in the diagnosis of LMC had been reported as between 65% and 75%. 7 Park et al 10 reported that with the additional consideration of positive CSF cytology results, the diagnostic sensitivity of MRI increased up to 91%, although the sensitivity of CSF cytology alone for LC was at most 54%. CSF samples collected from patients with LMC usually exhibit increased pressure, pleocytosis, elevated levels of protein and lactate dehydrogenase (LDH), and hypoglycaemia.…”