Autopsy diagnosis of leptomeningeal carcinomatosis, the first manifestation of gastric adenocarcinoma: a rare case report and review of the literature
Gastroenterology and Hepatology from Bed to Bench,
26 April 2021
This study aimed to report an unusual presentation of an advanced gastric adenocarcinoma. Leptomeningeal carcinomatosis is a rare event in gastric adenocarcinoma. It is much more uncommon as the primary manifestation in post-mortem evaluation of the cause of death in a patient presenting with headache and neurological signs and symptoms. Herein, we discuss our experience with a case of gastric adenocarcinoma, who was diagnosed after death, presenting with neurological signs and symptoms of leptomeningeal carcinomatosis. A 52-year-old gentleman presented with intractable headache and neck pain as well as vertigo. His physical examination showed only decreased deep tendon reflexes. He died after a short period of coma. Post-mortem evaluation showed numerous signet ring cells in the subarachnoid space as well as gastric malignant ulcer. In patients with intractable headache with no identifiable cause, meningeal involvement and infiltration should be considered as the probable underlying cause. Radiologic findings are not significant; however, lumbar puncture can be diagnostic.
Keywords: leptomeningeal carcinomatosis, gastric adenocarcinoma, autopsy.
(Please cite as: Geramizadeh B, Fereidooni M, Dehghan AR, Bagheri-Lankarani K. Autopsy diagnosis of leptomeningeal carcinomatosis, the first manifestation of gastric adenocarcinoma: a rare case report and review of the literature. Gastroenterol Hepatol Bed Bench 2021;14(3):276-280).
- leptomeningeal carcinomatosis
- gastric cancer
Saad N, Alsibai A, Hadid TH. Carcinomatous meningitis due to gastric adenocarcinoma: A rare presentation of relapse. World J Gastrointest Oncol 2014;6:450-3.
Tomita H, Yasui H, Boku N, Nakasu Y, Mitsuya K, Onozawa Y, et al. Leptomeningeal carcinomatosis associated with gastric cancer. Int J Clin Oncol 2012;17:361-6.
Abdo AA, Coderre S, Bridges RJ. Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: A case report and review of the literature. Can J Gastroenterol 2002;16:807-11.
Fuchizaki U, Ohta H, Kaneko S. Image of the month. Gastroenterology 2005;128:1773.
Kon T, Funamizu Y, Miki Y, Tomiyama M, Baba M, Kurotaki H, Wakabayashi K. An autopsy case of meningeal carcinomatosis with parenchymal invasion through the cranial and spinal nerve roots. Neuropathology 2014;34:499-503.
Hayashi Y, Kato T, Tanaka Y, Yamada M, Koumura A, Kimura A, et al. Markedly Ring-enhanced Optic Nerves Due to Metastasis of Signet-ring Cell Gastric Carcinoma. Int Med 2010;49:517.
Guo JW, Zhang XT, Chen XS, Zhang XC, Zheng GJ, Cai YF. Leptomeningeal carcinomatosis as the initial manifestation of gastric adenocarcinoma: A case report. World J Gastroenterol 2014;20:2120-6.
Ohno T, Yokoyama Y, Aihara R, Mochiki E, Asao T, Kuwano H. Sudden Bilateral Sensorineural Hearing Loss as the Presenting Symptom of Meningeal Carcinomatosis of Gastric Cancer: Report of a Case. Surg Today 2010;40:561-5.
Lee HG, Lee B, Kim SM, Suh BJ, Yu HJ. A Case of Gastric Adenocarcinoma Presenting as Meningeal Carcinomatosis. Korean J Internal Med 2007:22:304-7.
Ho TH, FC Y, HW K, SJ C, Lee JT, LW W, HC C, et al. Acute lethargy in a young woman due to latent disseminated cancer mimicking bacterial meningitis: a diagnostic pitfall. Am J Emerg Med 2016;34:2050e5-e7.
Braeunigera S, Mwrina C, Mawrina C, Malfertheinerb P, Schildhausc HU, Seilerc C, et al. Gastric adenocarcinoma with leptomeningeal carcinomatosis as the presenting manifestation: an autopsy case report. Eur J Gastroenterol Hepatol 2005;17:577-9.
Hollingera P, Humma AM, Weisb J, Sturzeneggera M. Meningeal Carcinomatosis: Two Unusual Clinical, Laboratory, and Radiological Presentations. Eur Neurol 2002;48:44-9.
- Abstract Viewed: 0 times
- PDF Downloaded: 0 times