Scholarly Research Exchange

Scholarly Research Exchange / 2009 / Article

Case Report | Open Access

Volume 2009 |Article ID 642154 | 6 pages | https://doi.org/10.3814/2009/642154

Leptomeningeal Carcinomatosis Secondary to Gastroesophageal Adenocarcinoma: A Case Report and Literature Review of a Rare Occurrence

Received23 Aug 2008
Revised24 Oct 2008
Accepted17 Feb 2009
Published11 Mar 2009

Abstract

We present a 68-year-old male with leptomeningeal carcinomatosis (LC) from gastroesophageal junction carcinoma. Three months following epirubicin, cisplatin, 5-flurouracil (ECF) chemotherapy, the patient suffered from gait imbalance, headache, and dysarthria. CT and MRI imaging revealed LC throughout the brain and spine. The patient was prescribed dexamethasone and treated with a course of palliative radiation to the whole brain, 2000cGy/5. Additionally, the regions of symptomatic disease in the spine included the top of L4 vertebrae to the bottom of the S2 vertebrae which was treated with 2000cGy/5, and the top of the C5 vertebrae to the bottom of the T4 vetebrae received 800cGy/1. The radiation treatment did provide short-term symptom control; however, the patient eventually passed away from his illness. While LC remains a devastating complication of malignant disease, it has been rarely discussed in GI tumors, specifically GE junction adenocarcinomas. Therefore treatment options must be considered using first principles based on management of LC in more common disease sites. With early detection, and for patients with good performance status, palliative radiation utilizing hypofractionated regimens to sites of symptomatic involvement may improve quality of life for this group of unfortunate people.

References

  1. S. Taillibert, F. Laigle-Donadey, C. Chodkiewicz, M. Sanson, K. Hoang-Xuan, and J.-Y. Delattre, “Leptomeningeal metastases from solid malignancy: a review,” Journal of Neuro-Oncology, vol. 75, no. 1, pp. 85–99, 2005. View at: Publisher Site | Google Scholar
  2. H. G. Lee, B. Lee, S. M. Kim, B. J. Suh, and H. J. Yu, “A case of gastric adenocarcinoma presenting as meningeal carcinomatosis,” The Korean Journal of Internal Medicine, vol. 22, no. 4, pp. 304–307, 2007. View at: Publisher Site | Google Scholar
  3. H. Okumura, S. Natsugoe, N. Yokomakura et al., “A case of leptomeningeal carcinomatosis from esophageal basaloid carcinoma diagnosed by quantitative reverse transcription-polymerase chain reaction for carcinoembryonic antigen,” Journal of Gastroenterology, vol. 40, no. 1, pp. 87–93, 2005. View at: Publisher Site | Google Scholar
  4. Y. Lisenko, A. J. Kumar, J. Yao, J. Ajani, and L. Ho, “Leptomeningeal carcinomatosis originating from gastric cancer: report of eight cases and review of the literature,” American Journal of Clinical Oncology, vol. 26, no. 2, pp. 165–170, 2003. View at: Publisher Site | Google Scholar
  5. G. Y. Ku, G. Krol, and D. H. Ilson, “Successful treatment of leptomeningeal disease in colorectal cancer with a regimen of bevacizumab, temozolomide, and irinotecan,” Journal of Clinical Oncology, vol. 25, no. 13, pp. 14e–16, 2007. View at: Publisher Site | Google Scholar
  6. K. Goddeeris, C. Verslype, G. Wilms, and E. Van Cutsem, “Leptomeningeal carcinomatosis associated with oesophageal adenocarcinoma: two case reports and review of the literature,” Acta Gastro-Enterologica Belgica, vol. 69, no. 4, pp. 377–380, 2006. View at: Google Scholar
  7. A. A. Abdo, S. Coderre, and R. J. Bridges, “Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: a case report and review of the literature,” Canadian Journal of Gastroenterology, vol. 16, no. 11, pp. 807–811, 2002. View at: Google Scholar
  8. L. E. Abrey, M. C. Chamberlain, and H. H. Engelhar, Eds., Leptomeningeal Metastases, Cancer Treatment and Research, Edited by S. T. Rosen, Springer, Glenwood Springs, Colo, USA, 2005.
  9. G. Bonadonna, G. N. Hortobagyi, and A. M. Gianni, Eds., Textbook of Breast Cancer: A Clinical Guide to Therapy, Martin Dunitz/Taylor & Francis, London, UK, 2nd edition, 2001.
  10. J.-L. Lee, Y.-K. Kang, T.-W. Kim et al., “Leptomeningeal carcinomatosis in gastric cancer,” Journal of Neuro-Oncology, vol. 66, no. 1-2, pp. 167–174, 2004. View at: Publisher Site | Google Scholar

Copyright © 2009 Gunita Mitera et al. 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.


More related articles

133 Views | 0 Downloads | 0 Citations
 PDF  Download Citation  Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles

We are committed to sharing findings related to COVID-19 as quickly and safely as possible. Any author submitting a COVID-19 paper should notify us at help@hindawi.com to ensure their research is fast-tracked and made available on a preprint server as soon as possible. We will be providing unlimited waivers of publication charges for accepted articles related to COVID-19. Sign up here as a reviewer to help fast-track new submissions.