Yeni Tanı Mide Karsinomlu Hastada İzole Leptomeningeal Karsinomatozis

43 yaşında bir erkek karın ağrısı ve hematemez ile kabul edildi. Hasta Endoskopik biopsi ile Mide karsinomu tanısı aldı ve Total Gastrektomi yapıldı.Gastrektomi'nin 6.gününde, baş ağrısı ve çift görme yakınması oldu.Beyin MRI bilateral serebellar hemisferde kontrast artışı ve Leptomeningeal kalınlaşma gözlendi.Birinci Serebrospinal sıvı muayenesinde maliğn hücre gözlenmedi,İkinci inceleme maliğn hücre şüphesi içermekteydi.Hastanın Leptomeningeal Karsinomatosis ile uyumlu klinik ve Radyolojik değerlendirmelerinden dolayı, İntratekal Kemoterpi uygulandı ve Hastanın nörolojik semptomları düzeldi.

Isolated Leptomeningeal Carcinomatosis in a Patient with Newly Diagnosed Gastric Cancer

A 43 year-old man admitted with abdominal pain and hematemesis. He diagnosed with gastric cancer by endoscopic biopsy and total gastrectomy was carried out. On the sixth day of gastrectomy he complained about headache and diplopia. Magnetic resonance imaging of the brain showed leptomeningeal thickening and contrast enhancement of bilateral cerebellar hemisphere. First cerebrospinal fluid examination revealed no malignant cells, the second one was suspicious for malignant cells. Because of the radiological and clinical evaluation of the patient compatible with the Leptomeningeal Carcinomatosis, intrathecal chemotherapy was performed and his neurological symptoms were improved.

___

  • Wasserstrom WR, Glass JP, Posner JB. Diagnosis and treatment of leptomeningeal metastases from solid tumors. Experience with 90 patients. Cancer 1982;49:759-72 2. Grossman SA, Krabak carcinomatosis. Cancer Treat Rev 1999;25:103-9
  • Lee JL, Kang YK, Kim TW et al. Leptomeningeal carcinomatosis in gastric cancer. J Neurooncol 2004;66:167-74
  • Kim M. Intracranial involvement by metastatic gastric carcinoma. J Neurooncol 1999;43:59-62
  • Aiello–Laws L, Rutledge DN. Management of adult patients receiving intraventriculer chemotherapy for the treatment of leptomeningeal metastasis. Clin J Oncol Nurs 2008;12:429-435
  • Lisenko Y, Kumar AJ, Yao J, et al. Leptomeningeal carcinomatosis orginating from gastric cancer. Am J Clin Oncol 2003;26:165-70
  • Rudnicka H, Niwinska A, Gruszfelt A, Pienkowski T. Diagnosis and treatment of carcinoid meningitis: a challenge to the neurologist and oncologist. Neurol Neurochir Pol 2003;37:811-24
  • Kim L, Glantz M. Neoplastic meningitis. Curr Treat Options Oncol 2001;2:517-27 9. Balm M, Hammack J. Leptomeningeal
  • carcinomatosis. Presenting features and prognostic
  • factors. Arch Neurol 1996;53:626-32
  • Giannone L, Greco FA, Hainsworth JD. Combination intraventricular neoplasia. J Clin Oncol 1986;4:68-73 for meningeal
  • Hitchins RN, Bell DR, Woods RL, Levi JA. A prospective randomized trial of single-agent versus combination carcinomatosis. J Clin Oncol 1987;5:1655-62 in meningeal
  • Bleyer WA, Drake JC, Chabner BA. Neurotoxicity and concentration in meningeal leukemia. N Engl J Med 1973;289:770-3 methotrexate
  • Oh SY, Lee SJ, Lee J, et al. Gastric Leptomeningeal carcinomatosis: multi-center retrospective analysis of 54 cases. World J Gastroenterol 2009;15:5086-90
Acta Oncologica Turcica-Cover
  • ISSN: 0304-596X
  • Başlangıç: 2015
  • Yayıncı: Dr. Abdurrahman Yurtaslan Ankara Onkoloji EAH