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
Aim: To report an unusual presentation of an advanced gastric adenocarcinoma
Background: 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 manifested with headache and neurological signs and symptoms. Herein we will discuss our experience with a case of gastric adenocarcinoma who was diagnosed after death presenting with neurological signs and symptoms of leptomeningeal carcinomatosis.
Patients and methods: 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.
Results: Post-mortem evaluation showed numerous signet ring cells in the subarachnoid space as well as gastric malignant ulcer.
Conclusion: 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.
Key Words; Leptomeningeal carcinomatosis, Gastric adenocarcinoma, Autopsy
- leptomeningeal carcinomatosis
- gastric cancer
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