An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung.
Affiliation
Department of Oncology, Christie NHS Foundation Trust, Manchester, UKIssue Date
2018-06-21
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A 72-year-old man was brought to the emergency department with acute onset confusion and haemoptysis. Chest X-ray showed a possible lung mass, while CT head showed a fluid-filled, space-occupying lesion (SOL) in the right frontal lobe of the brain. MRI head indicated that this SOL had spilt its contents into the subarachnoid and intraventricular spaces. Due to a fluctuating Glasgow Coma Scale (GCS), the patient underwent emergency debulking. Macroscopically, a frail-walled cystic tumour filled with straw-coloured fluid was noted; histology confirmed metastasis from a primary lung adenocarcinoma. Whole brain radiotherapy was given, with a view to commence systemic therapy. The patient, however, deteriorated and unfortunately passed away a few weeks after completing radiotherapy. This patient presented with leptomeningeal metastasis as the first presentation of a lung adenocarcinoma, and had a highly unusual mechanism by which leptomeningeal spread had occurred, with metastatic brain tumour spilling its contents into the meningeal spaces.Citation
An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung. 2018, 2018 BMJ Case RepJournal
BMJ Case ReportsDOI
10.1136/bcr-2017-223649PubMed ID
29930180Type
ArticleLanguage
enISSN
1757-790Xae974a485f413a2113503eed53cd6c53
10.1136/bcr-2017-223649
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