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Case Reports in Hepatology
Volume 2014, Article ID 717403, 3 pages
http://dx.doi.org/10.1155/2014/717403
Case Report

Leptomeningeal Dissemination in Gall Bladder Carcinoma: Sequelae of Long-Term Survival?

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110019, India

Received 24 July 2014; Accepted 14 October 2014; Published 5 November 2014

Academic Editor: Hideaki Uchiyama

Copyright © 2014 Shikha Goyal and Bidhu Kalyan Mohanti. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with gall bladder malignancies usually present at an advanced stage with less than 20% cases being resectable at presentation and over a half harbouring distant metastases to liver or paraaortic nodes. Long-term cure is uncommon and so is the presence of central nervous system metastases. We present the case of a middle-aged woman with adenocarcinoma gall bladder, treated with postoperative locoregional irradiation following simple cholecystectomy, who developed headache, backache, vision loss, and multiple joint pains six years following adjuvant therapy. A diagnosis of leptomeningeal carcinomatous meningitis was established with cerebrospinal fluid cytology positivity for carcinoma. She deteriorated on palliative cranial irradiation and was managed with best supportive care.