Open AccessRare case of pancreatic cancer with leptomeningeal carcinomatosis
Author(s) -
In Kyung Yoo,
Hong Sik Lee,
Chang Duk Kim,
Hoon Jai Chun,
Yoon Tae Jeen,
Bora Keum,
Eun Sun Kim,
Hyuk Soon Choi,
Jae Min Lee,
Seung Han Kim,
SeungJoo Nam,
Jong Jin Hyun
Publication year - 2015
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v21.i3.1020
Subject(s) - medicine , leptomeninges , meningeal carcinomatosis , pancreatic cancer , cerebrospinal fluid , pathology , magnetic resonance imaging , carcinosis , vomiting , cancer , metastasis , radiology , central nervous system , peritoneal carcinomatosis , colorectal cancer
Leptomeningeal carcinomatosis occurs very rarely in patients with pancreatic cancer. Leptomeningeal carcinomatosis is characterized by multifocal seeding of the leptomeninges by malignant cells that originate from a solid tumor. To the best of our knowledge, brain metastasis from pancreatic cancer is extremely rare. Leptomeningeal carcinomatosis is estimated to occur in 3% to 8% of cases of solid tumors. The clinical manifestation usually involves neurological symptoms, including dizziness, headache, vomiting, nausea, and hemiparesis, symptoms similar to those of meningitis or brain tumors. Diagnostic methods for leptomeningeal carcinomatosis include brain magnetic resonance imaging and cerebrospinal fluid examination. Here, we describe a case of leptomeningeal carcinomatosis in which the primary tumor was later determined to be pancreatic cancer. Brain magnetic resonance imaging findings showed mild enhancement of the leptomeninges, and cerebrospinal fluid cytology was negative at first. However, after repeated spinal taps, atypical cells were observed on cerebrospinal fluid analysis and levels of tumor markers such as carbohydrate antigen 19-9 in cerebrospinal fluid were elevated. Abdominal computed tomography, performed to determine the presence of extracerebral tumors, revealed pancreatic cancer. Pancreatic cancer was confirmed histopathologically on examination of an endoscopic ultrasound-guided fine needle aspiration specimen.