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

  • 1Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea. lhggi@yahoo.co.kr
  • 2Korean Gastric Cancer Center, Inje University Seoul Paik Hospital, Seoul, Korea.


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.


Neoplasm; Leptomeningeal; Carcinoma; Signet Ring Cell

MeSH Terms

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