Kim Nam-Hee, Kim Ji-Hyun, Chin Hyung-Min, Jun Kyong-Hwa
Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
Ann Surg Treat Res. 2014 Jan;86(1):16-21. doi: 10.4174/astr.2014.86.1.16. Epub 2014 Jan 1.
The aim of this study is to investigate the clinical features and outcomes of 9 consecutive patients who suffered with leptomeningeal carcinomatosis (LMC) originating from gastric cancer.
Between January 1995 and December 2010, we retrospectively reviewed the medical records of 9 patients with gastric LMC who had been treated at St. Vincent's Hospital, The Catholic University of Korea.
With the exception of 1 patient, the primary gastric cancer was Borrmann type III or IV, and 5 cases had poorly differentiated or signet ring cell histology. TNM stage of the primary gastric cancer was III in 6 patients. The median interval from diagnosis of the primary malignancy to the diagnosis of LMC was 9 months. Headache (6 cases), altered mental status (4 cases), and dysarthria (3 cases) were presenting symptoms of LMC. Computed tomography findings were abnormal in 4 of 7 cases, while magnetic resonance imaging revealed abnormality in 4 of 5 cases. Radiation therapy was administered to 5 patients and intrathecal chemotherapy was administered to only 1 patient. Median overall survival duration from the diagnosis of LMC was 3 months.
LMC originating from gastric cancer had a fatal clinical course and treatment strategies remain challenging.
本研究旨在调查9例源自胃癌的柔脑膜癌病（LMC）患者的临床特征及预后。
1995年1月至2010年12月期间，我们回顾性分析了韩国天主教大学圣文森特医院收治的9例胃LMC患者的病历。
除1例患者外，原发性胃癌为Borrmann III型或IV型，5例组织学类型为低分化或印戒细胞癌。6例原发性胃癌的TNM分期为III期。从原发性恶性肿瘤诊断到LMC诊断的中位间隔时间为9个月。头痛（6例）、精神状态改变（4例）和构音障碍（3例）是LMC的主要症状。7例患者中4例计算机断层扫描结果异常，5例患者中4例磁共振成像显示异常。5例患者接受了放射治疗，仅1例患者接受了鞘内化疗。从LMC诊断开始计算的中位总生存时间为3个月。
源自胃癌的LMC临床病程凶险，治疗策略仍具有挑战性。
