Shibata Tomotaka, Kikuchi Nobuyuki, Moroga Toshihiko, Tanaka Eiichi, Noguchi Tsuyoshi
Dept. of Surgery, Shinbeppu Hospital.
Gan To Kagaku Ryoho. 2009 Dec;36(13):2649-51.
The development of chemotherapy to treat gastric cancer has prolonged its prognosis, and sometimes extremely rare conditions arise. This report describes two patients with carcinomatous meningitis who rapidly progressed into unconsciousness and died. A 60-year-old woman under second-line chemotherapy for gastric cancer presented with headache and disordered speech. Magnetic resonance imaging (MRI) indicated carcinomatous meningitis, and a lumbar puncture revealed cancer cells in the cerebrospinal fluid. Convulsions rapidly progressed while unconscious, and the patient died two weeks after admission. A 67-year-old man receiving adjuvant chemotherapy after total gastrectomy for gastric cancer was admitted to the emergency department with severe fatigue and appetite loss. Unconsciousness rapidly progressed on the following day and carcinomatous meningitis was diagnosed. The patient died two weeks later. Carcinomatous meningitis is a rare complication of gastric cancer that rapidly progresses often to death, and it should be recalled that it is accompanied by a rapid loss of consciousness.
用于治疗胃癌的化疗发展延长了其预后，但有时会出现极其罕见的情况。本报告描述了两名患有癌性脑膜炎的患者，他们迅速陷入昏迷并死亡。一名60岁的女性在接受胃癌二线化疗时出现头痛和言语紊乱。磁共振成像（MRI）显示为癌性脑膜炎，腰椎穿刺在脑脊液中发现癌细胞。患者在昏迷中抽搐迅速加重，入院两周后死亡。一名67岁的男性在胃癌全胃切除术后接受辅助化疗，因严重疲劳和食欲减退入住急诊科。次日迅速陷入昏迷，被诊断为癌性脑膜炎。患者两周后死亡。癌性脑膜炎是胃癌罕见的并发症，常迅速进展至死亡，应记住其常伴有意识快速丧失。
