Kokavec Andrew, Laba Joanna
Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, London, CAN.
Radiation Oncology, London Health Sciences Centre, London, CAN.
Cureus. 2024 Mar 22;16(3):e56727. doi: 10.7759/cureus.56727. eCollection 2024 Mar.
Leptomeningeal disease (LMD) is a rare complication of advanced non-small cell lung cancer (NSCLC), associated with a poor prognosis. We report the case of a 55-year-old man, who presented with a metastatic NSCLC with limited brain and abdominal metastases. He was treated with both chemoimmunotherapy and stereotactic radiotherapy (SRT) to the brain. Despite treatment, the patient experienced progressive neurological symptoms not in keeping with the extent of disease seen on imaging of the brain. Due to this incongruence between symptoms and radiologic findings, he underwent a lumbar puncture, which had positive cytology for LMD. He had a rapid progression of symptoms and died six days after the discovery of LMD. We review the available literature regarding the prevalence of MRI-negative LMD from a solid primary malignancy.
软脑膜疾病（LMD）是晚期非小细胞肺癌（NSCLC）的一种罕见并发症，预后较差。我们报告了一例55岁男性病例，该患者患有转移性NSCLC，脑和腹部转移灶有限。他接受了化疗免疫治疗和脑部立体定向放射治疗（SRT）。尽管进行了治疗，但患者仍出现了与脑部影像学所见疾病范围不符的进行性神经症状。由于症状与放射学检查结果不一致，他接受了腰椎穿刺，脑脊液细胞学检查显示LMD呈阳性。他的症状迅速进展，在发现LMD后六天死亡。我们回顾了有关实体原发性恶性肿瘤中MRI阴性LMD患病率的现有文献。
