Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine Graduate School of Medicine, Japan.
Division of Gastroenterology, Yokohama Chuo Hospital, Japan.
Intern Med. 2021 Dec 1;60(23):3743-3748. doi: 10.2169/internalmedicine.4456-20. Epub 2021 Jun 19.
A 57-year-old woman with a sudden-onset seizure was hospitalized. Brain magnetic resonance imaging findings led to a suspicion of leptomeningeal carcinomatosis (LMC) without a brain parenchymal tumor, and abdominal computed tomography showed a tumor in the pancreatic tail. Endoscopic ultrasonography-guided fine needle aspiration of the pancreatic mass revealed adenocarcinoma. Therefore, LMC from pancreatic ductal adenocarcinoma was strongly suspected. She received three courses of nab-paclitaxel plus gemcitabine and whole-brain radiation. Shortly thereafter, she developed a severe consciousness impediment and died. A pathological autopsy showed adenocarcinoma in a wide area of the leptomeninges.
一位 57 岁女性突发癫痫,被收入院治疗。脑部磁共振成像检查结果提示脑膜转移癌(LMC),但无脑部实质肿瘤,腹部计算机断层扫描显示胰尾有肿瘤。超声内镜引导下胰腺肿块细针抽吸活检显示腺癌。因此,强烈怀疑 LMC 来源于胰腺导管腺癌。她接受了三个疗程的nab-紫杉醇联合吉西他滨和全脑放疗。此后不久,她出现严重的意识障碍并死亡。病理尸检显示软脑膜的广泛区域有腺癌。