RT Journal Article
SR Electronic
T1 An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-223649
DO 10.1136/bcr-2017-223649
VO 2018
A1 Tinsley, Nadina
A1 Yemula, Nikitha
A1 Ramalingam, Satheesh
A1 Madathil, Shyam
YR 2018
UL http://casereports.bmj.com/content/2018/bcr-2017-223649.abstract
AB 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.