Güçsav Mutlu Onur, Ayrancı Aysu, Polat Gülru, Karadeniz Gülistan, Demirci Üçsular Fatma, Öztekin Özgür, Bozkurt Mediha Tülin, Akyol Murat, Yalnız Enver
Division of Chest Diseases, University of Health Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Turkey.
Division of Radiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.
Tuberk Toraks. 2018 Dec;66(4):340-344. doi: 10.5578/tt.67609.
Leptomeningeal metastasis is a very rare complication of infiltration of leptomeninges and subarachnoid space with malignant cells. It is an indicator of poor prognosis. Its incidence is 3.8% in non-small cell lung carcinoma (NSCLC). This rate is higher in patients with epidermal growth factor receptor (EGFR) mutation. Brain magnetic resonance imaging (MRI) is the first choice in the diagnosis. The diagnosis of leptomeningeal metastasis is difficult and often bypassed because it is rare and does not cause gross mass lesions such as brain metastasis. Systemic chemotherapy, intrathecal therapy, cranial radiotherapy and targeted treatment agents are an option in the treatment. It has been shown that targeted therapies can be promising because of the ability to switch to cerebrospinal fluid in appropriate patients. We present the case with EGFR positive lung adenocarcinoma whit leptomeningeal metastasis (LM) due to its rarity, difficulty in diagnosis and its association with EGFR mutation.
软脑膜转移是恶性细胞浸润软脑膜和蛛网膜下腔的一种非常罕见的并发症。它是预后不良的一个指标。在非小细胞肺癌（NSCLC）中其发生率为3.8%。在表皮生长因子受体（EGFR）突变的患者中该发生率更高。脑磁共振成像（MRI）是诊断的首选。软脑膜转移的诊断困难且常被漏诊，因为其罕见且不引起如脑转移那样的明显肿块病变。全身化疗、鞘内治疗、颅脑放疗和靶向治疗药物是治疗的选择。已经表明，由于在合适的患者中能够进入脑脊液，靶向治疗可能很有前景。我们报告一例EGFR阳性肺腺癌伴软脑膜转移（LM）的病例，因其罕见、诊断困难以及与EGFR突变的关联。
