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KMID : 0857019990140010065
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Kosin Medical Journal
1999 Volume.14 No. 1 p.65 ~ p.71
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Clinical Study on Leptomeningeal Carcinomatosis
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Kim Meyung-Kug
Kim Min-Jeong
Kim Kwang-Soo
Yoo Kyung-Moo
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Abstract
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Background : Carcinomatous meningitis is a rare and often devastating complication in solid tumor patients.
Methods : We reviewed 12 cases of leptomeningeal carcinomatosis seen at the Kosin University Gospel Hospital from Mar. 1993 to Jul. 1999. Leptomeningeal carcinomatosis were comfirmed by characteristic clinical symptoms, abnormal neuroimaging findings, elevated cerebrospinal fluid (CSF) carcinoembryonic antigen (CEA) titer, and positive CSF cytology.
Results : The primary cancers of leptomeningeal carcinomatosis were lung cancer, stomach cancer, rectal cancer, and breast cancer. In one case the primary site was not identified. Clinical manifestations were headache, nausea, vomiting, and nuchal rigidity. The positive yields in the diagnosis of leptomeningeal carcinomatosis were 88.9% in CSF CEA titer, 72.7% in CSF cytology, and 58.3% in neuroimaging. Mean survival after diagnosis was 19 days with conservative treatment, and 44 days with intrathecal chemotherapy.
Conclusions : For early diagnosis of lepto eningeal carcinomatosis, it is important to consider CSF CEA titer as well as CSF cytology.
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KEYWORD
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Leptomeningeal carcinomatosis, CSF CEA
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