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Leptomeningeal
carcinomatosis in gastric cancer
Jae-Lyun Lee, Yoon-Koo
Kang, Tae-Won Kim, Heung-Moon Chang, Gyeong-Won Lee, Min-Hee Ryu, Eunkyoung Kim,
Seok-Joong Oh, Je-Hwan Lee, Sung-Bae Kim, Sang-We Kim, Cheolwon Suh, Kyoo-Hyung
Lee, Jung-Shin Lee, Woo-Kun Kim and Sang-Hee Kim
Department of Medicine,
Division of Oncology–Hematology, University of Ulsan College of Medicine, Asan
Medical Center, Seoul, Republic of Korea
We analyzed 19 cases of
cytologically confirmed leptomeningeal carcinomatosis (LMC) treated at our
institution over the past 11
years.
LMC was the initial manifestation of gastric cancer in 2 patients.
With the exception of 1 patient,
the primary gastric cancer was Borrmann type III or IV, and 88% had poorly
differentiated or signet-ring cell
histology.
The gastric cancer was progressive or a recurrent disease in most of the
patients.
The distribution of extraneural
metastasis suggested that Batson’s venous plexus might be the predominant
route to the subarachnoid space.
Eighty percent of the patients had multiple neuraxis syndrome, and the
combination of brain plus cranial nerve
syndrome was the most common manifestation.
Computed tomography (CT) findings were abnormal in a minor
proportion of the patients, while magnetic resonance imaging (MRI) revealed
abnormality in 67% of the patients,
which could help the diagnosis.
LMC complicating gastric cancer was ultimately fatal.
Median survival was very short, 4
weeks.
By univariate analysis, good performance status, intrathecal chemotherapy, and
low CSF LDH concentration favored
survival.
Multivariate analysis revealed that the administration of CSF chemotherapy was
the independent prognostic factor for survival.
Key words: gastric
adenocarcinoma, leptomeningeal carcinomatosis
© 2004 Kluwer Academic
Publishers. Printed in the Netherlands.
Source: http://journals.kluweronline.com/article.asp?PIPS=5138399
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