A case of metastatic leptomeningeal carcinomatosis from early gastric carcinoma
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
A case of metastatic leptomeningeal carcinomatosis from early gastric carcinoma Kwang-Kuk Park1, Song-I Yang1, Kyung-Won Seo1, Young-Ok Kim2 and Ki-Young Yoon1*
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. Keywords: Early gastric cancer, Carcinomatosis, Leptomeningeal, Signet ring cell
Background Gastric cancer is one of the most commonly diagnosed malignancies in Korea, and the third most common cause of mortality [1]. Most patients with gastric cancer eventually develop cachexia and peritoneal carcinomatosis and die of multiple organ failure. Early gastric cancer is defined as adenocarcinoma of the stomach confined to the mucosa or submucosa, regardless of the presence of lymph node metastasis [2]. Although the 5-year survival rate of early gastric cancer exceeds 85% in most series [3], some cases are associated with distant metastasis. Brain metastasis of gastric cancer in particular is rare, and leptomeningeal carcinomatosis is even less common. Leptomeningeal carcinomatosis is defined as the dissemination and growth of cancer cells within the leptomeningeal space. Metastatic leptomeningeal carcinomatosis is estimated to occur in 3% to 8% of solid carcinomas [4]. In this report, we present a
* Correspondence: [email protected] 1 Department of Surgery, Kosin University College of Medicine, Busan, South Korea Full list of author information is available at the end of the article
rare case of early gastric cancer leading to leptomeningeal carcinomatosis.
Case presentation A 69-year-old woman with a history of early gastric cancer was admitted to our hospital with a 3-day history of general weakness, headache and nausea. On physical examination she was pale and appeared acutely ill, but was oriented to person, place and time. Her vital signs were as foll
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