Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
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A Case of Advanced Gastric Cancer with Multiple Leptomeningeal Metastasis

진행성 위암의 추적 관찰 도중 다발성 수막내 전이가 발견된 환자 1례

  • Hae Jin Shin (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Hyun Yong Jeong (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Hee Seok Moon (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Jae Kyu Sung (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Sun Hyung Kang (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine)
  • 신해진 (충남대학교 의학전문대학원 내과학교실, 소화기내과) ;
  • 정현용 (충남대학교 의학전문대학원 내과학교실, 소화기내과) ;
  • 문희석 (충남대학교 의학전문대학원 내과학교실, 소화기내과) ;
  • 성재규 (충남대학교 의학전문대학원 내과학교실, 소화기내과) ;
  • 강선형 (충남대학교 의학전문대학원 내과학교실, 소화기내과)
  • Received : 2016.06.07
  • Accepted : 2016.12.22
  • Published : 2016.12.31
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Abstract

Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

Keywords

References

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