Leptomeningeal Carcinomatosis in Early Gastric Cancer: A Case Report and Literature Review

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2024 Jun 26

PMID 38921299

Authors

Alessio Lucarini

Giulia Arrivi

Elena Liotta

Francesco Saverio Li Causi

Leonardo Di Cicco

Federica Mazzuca

Mattia Falchetto Osti

Genoveffa Balducci

Paolo Mercantini

Affiliations

Soon will be listed here.

Abstract

Leptomeningeal carcinomatosis (LC) is a rare site of metastasis in solid tumors, and it is associated with poor prognosis due to disabling symptoms and a scarcity of treatment options. This condition is an uncommon entity in gastric cancer (GC). We present a case of primary LC manifestation in a patient with an incidental diagnosis of localized node-negative GC. We additionally perform a literature review and discuss the diagnostic and therapeutic challenges. In conclusion, LC from GC represents a rare condition with a dramatic prognosis. Its diagnosis might be very challenging. A multidisciplinary approach appears to be the best strategy for the management of LC from GC.

References

Ohno T, Yokoyama Y, Aihara R, Mochiki E, Asao T, Kuwano H . Sudden bilateral sensorineural hearing loss as the presenting symptom of meningeal carcinomatosis of gastric cancer: report of a case. Surg Today. 2010; 40(6):561-5. DOI: 10.1007/s00595-009-4099-1. View

Guo J, Zhang X, Chen X, Zhang X, Zheng G, Zhang B . Leptomeningeal carcinomatosis as the initial manifestation of gastric adenocarcinoma: a case report. World J Gastroenterol. 2014; 20(8):2120-6. PMC: 3934485. DOI: 10.3748/wjg.v20.i8.2120. View

Le Rhun E, Weller M, van den Bent M, Brandsma D, Furtner J, Ruda R . Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open. 2023; 8(5):101624. PMC: 10619142. DOI: 10.1016/j.esmoop.2023.101624. View

Mercantini P, Lucarini A, Mazzuca F, Osti M, Laghi A . How technology can help in oncologic patient management during COVID-19 outbreak. Eur J Surg Oncol. 2020; 46(6):1189-1191. PMC: 7192092. DOI: 10.1016/j.ejso.2020.04.050. View

Le Rhun E, Devos P, Weller J, Seystahl K, Mo F, Compter A . Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors. Neuro Oncol. 2020; 23(7):1100-1112. PMC: 8301235. DOI: 10.1093/neuonc/noaa298. View

Cresto N, Barth A, Arnold M, Weimann R, Gschossmann J, Ochsenbein A . [Extraordinary manifestation of a gastric carcinoma by leptomeningeal carcinomatosis and spinal metastasis]. Med Klin (Munich). 2007; 102(3):255-8. DOI: 10.1007/s00063-007-1030-7. View

Riihimaki M, Hemminki A, Sundquist K, Sundquist J, Hemminki K . Metastatic spread in patients with gastric cancer. Oncotarget. 2016; 7(32):52307-52316. PMC: 5239553. DOI: 10.18632/oncotarget.10740. View

Zhang Y, Lin Y, Duan J, Xu K, Mao M, Wang X . A Population-Based Analysis of Distant Metastasis in Stage IV Gastric Cancer. Med Sci Monit. 2020; 26:e923867. PMC: 7245058. DOI: 10.12659/MSM.923867. View

Cavanna L, Seghini P, Di Nunzio C, Orlandi E, Michieletti E, Stroppa E . Gastric cancer with brain metastasis and the role of human epidermal growth factor 2 status. Oncol Lett. 2018; 15(4):5787-5791. PMC: 5840578. DOI: 10.3892/ol.2018.8054. View

10.

Megid T, Baskurt Z, Ma L, Barron C, Farooq A, Saltiel M . Leptomeningeal carcinomatosis and brain metastases in gastroesophageal carcinoma: a real-world analysis of clinical and pathologic characteristics and outcomes. J Neurooncol. 2024; 167(1):111-122. PMC: 10978709. DOI: 10.1007/s11060-024-04576-8. View

11.

Lordick F, Carneiro F, Cascinu S, Fleitas T, Haustermans K, Piessen G . Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022; 33(10):1005-1020. DOI: 10.1016/j.annonc.2022.07.004. View

12.

Balm M, Hammack J . Leptomeningeal carcinomatosis. Presenting features and prognostic factors. Arch Neurol. 1996; 53(7):626-32. DOI: 10.1001/archneur.1996.00550070064013. View

13.

Weston C, Glantz M, Connor J . Detection of cancer cells in the cerebrospinal fluid: current methods and future directions. Fluids Barriers CNS. 2011; 8(1):14. PMC: 3059292. DOI: 10.1186/2045-8118-8-14. View

14.

Mittica G, Senetta R, Richiardi L, Ruda R, Coda R, Castellano I . Meningeal carcinomatosis underdiagnosis and overestimation: incidence in a large consecutive and unselected population of breast cancer patients. BMC Cancer. 2015; 15:1021. PMC: 4696095. DOI: 10.1186/s12885-015-2042-y. View

15.

Singh S, Agris J, Leeds N, Ginsberg L . Intracranial leptomeningeal metastases: comparison of depiction at FLAIR and contrast-enhanced MR imaging. Radiology. 2000; 217(1):50-3. DOI: 10.1148/radiology.217.1.r00oc3550. View

16.

Lucarini A, Garbarino G, Orlandi P, Garofalo E, Bragaglia L, Laracca G . From "Cure" to "Care": The Role of the MultiDisciplinary Team on Colorectal Cancer Patients' Satisfaction and Oncological Outcomes. J Multidiscip Healthc. 2022; 15:1415-1426. PMC: 9249348. DOI: 10.2147/JMDH.S362550. View

17.

Garbarino G, Laracca G, Lucarini A, Piccolino G, Mercantini P, Costa A . Laparoscopic versus Open Surgery for Gastric Cancer in Western Countries: A Systematic Review and Meta-Analysis of Short- and Long-Term Outcomes. J Clin Med. 2022; 11(13). PMC: 9267365. DOI: 10.3390/jcm11133590. View

18.

Kim M . Intracranial involvement by metastatic advanced gastric carcinoma. J Neurooncol. 1999; 43(1):59-62. DOI: 10.1023/a:1006156204385. View

19.

Yamada T, Furukawa K, Yokoi K, Ohaki Y, Okada S, Tajiri T . Case of meningeal carcinomatosis with gastric cancer which manifested meningeal signs as the initial symptom; the palliative benefit of radiotherapy. J Nippon Med Sch. 2008; 75(4):216-20. DOI: 10.1272/jnms.75.216. View

20.

Fuchizaki U, Ohta H, Kaneko S . Image of the month. Gastric signet-ring-cell carcinoma with leptomeningeal carcinomatosis. Gastroenterology. 2005; 128(7):1773, 2181. DOI: 10.1053/j.gastro.2005.01.061. View