Lusilla Alejandro, de Tomás Jorge
Cirugía General, HGU Gregorio Marañón.
Cirugía General, HGU Gregorio Marañón, España.
Rev Esp Enferm Dig. 2017 Jul;109(7):535. doi: 10.17235/reed.2017.4602/2016.
We present the case report of a twenty-five-year-old Moroccan male patient who suffered from leptomeningeal carcinomatosis related to a signet-ring cell carcinoma of the rectum. He presented to the emergency department with abdominal pain, constipation, weight loss and rectal bleeding. The rectal examination showed a rectal tumor and a CT scan revealed a large bowel obstruction due to rectal diffuse thickening. An emergency transverse colostomy was performed, with a rectal biopsy and a cytological sample collection. The pathology analysis showed a signet-ring cell carcinoma from the rectum. The staging evaluation was completed and neoadjuvant chemotherapy and radiotherapy were offered to the patient. Two months later, he developed neurological signs of leptomeningeal involvement which was confirmed by a lumbar puncture. Then, the patient received systemic and intrathecal chemotherapy but later died. This case shows the tendency of colorectal signet-ring cell carcinomas to cause leptomeningeal metastasis, even in young patients.
我们报告一例25岁摩洛哥男性患者的病例，该患者患有与直肠印戒细胞癌相关的柔脑膜癌病。他因腹痛、便秘、体重减轻和直肠出血就诊于急诊科。直肠检查发现直肠肿瘤，CT扫描显示由于直肠弥漫性增厚导致大肠梗阻。进行了急诊横结肠造口术，并采集了直肠活检和细胞学样本。病理分析显示为直肠印戒细胞癌。完成分期评估后，为患者提供了新辅助化疗和放疗。两个月后，他出现了柔脑膜受累的神经学体征，腰椎穿刺证实了这一点。随后，患者接受了全身和鞘内化疗，但最终死亡。该病例表明，即使在年轻患者中，结直肠印戒细胞癌也有导致柔脑膜转移的倾向。
