Korean J Intern Med.  2007 Dec;22(4):304-307. 10.3904/kjim.2007.22.4.304.

A Case of Gastric Adenocarcinoma Presenting as Meningeal Carcinomatosis

• Lee HG
• Lee B
• Kim SM
• Suh BJ
• Yu HJ

• KMID: 1776687
• DOI: http://doi.org/10.3904/kjim.2007.22.4.304

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.

Keyword

Neoplasm; Leptomeningeal; Carcinoma; Signet Ring Cell

MeSH Terms

Adrenal Cortex Hormones
Carcinoma, Signet Ring Cell/*diagnosis/pathology/surgery
Female
Humans
Mannitol
Meningeal Neoplasms/*diagnosis/pathology/surgery
Middle Aged
Stomach Neoplasms/*diagnosis/pathology/surgery