Abdo Ayman A, Coderre Sylvain, Bridges Ronald J
University of Calgary, Calgary, Alberta.
Can J Gastroenterol. 2002 Nov;16(11):807-11; quiz 831-2. doi: 10.1155/2002/659125.
Leptomeningeal carcinomatosis (LC) is a rare metastatic complication of solid tumours. It has been mainly described in association with breast cancer, lung cancer and melanoma.
A patient presenting with progressive solid food dysphagia with documented adenocarcinoma of the lower esophagus and gastroesophageal junction is reported. One month after the initial diagnosis, the patient developed gradual onset of increasing headache and progressive decrease in the level of consciousness. Computed tomography of the head showed evidence of meningeal enhancement, and cerebrospinal fluid examination showed the presence of adenocarcinoma cells, making the diagnosis of LC. The patient died one month after LC was diagnosed.
LC is a poor prognostic sign in solid organ malignancies. It usually presents with headache, altered level of consciousness and focal neurological deficits. Diagnosis is established by finding malignant cells in the cerebrospinal fluid and supported by marked meningeal enhancement on computed tomography of the brain. A review of the English literature found only three reported cases of LC secondary to esophageal malignancy.
A case of LC complicating esophageal and gastroesophageal junction malignancy is described. A high index of suspicion and early diagnosis may influence the poor outcome of these patients.
软脑膜癌病（LC）是实体肿瘤罕见的转移并发症。主要见于乳腺癌、肺癌和黑色素瘤。
报告1例表现为进行性固体食物吞咽困难且确诊为食管下段和胃食管交界腺癌的患者。初始诊断1个月后，患者逐渐出现头痛加重和意识水平进行性下降。头部计算机断层扫描显示脑膜强化迹象，脑脊液检查发现腺癌细胞，从而确诊为LC。LC诊断1个月后患者死亡。
LC在实体器官恶性肿瘤中是预后不良的体征。通常表现为头痛、意识水平改变和局灶性神经功能缺损。通过在脑脊液中发现恶性细胞确诊，并通过脑部计算机断层扫描显示明显的脑膜强化来支持。回顾英文文献仅发现3例继发于食管恶性肿瘤的LC报告病例。
描述1例并发食管和胃食管交界恶性肿瘤的LC病例。高度怀疑和早期诊断可能会影响这些患者的不良预后。
