A case of leptomeningeal carcinomatosis involving loss of eyesight after total gastrectomy for gastric cancer
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- KUREBAYASHI Marie
- Department of Internal Medicine, Saiseikai-Matsusaka General Hospital
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- HASHIMOTO Akira
- Department of Internal Medicine, Saiseikai-Matsusaka General Hospital
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- IKENOYAMA Youhei
- Department of Internal Medicine, Saiseikai-Matsusaka General Hospital
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- TAHARA Yuichi
- Department of Internal Medicine, Saiseikai-Matsusaka General Hospital
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- FUKE Hiroyuki
- Department of Internal Medicine, Saiseikai-Matsusaka General Hospital
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- SHIMIZU Atsuya
- Department of Internal Medicine, Saiseikai-Matsusaka General Hospital
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- KONDO Masahide
- Department of Neurology, Saiseikai-Matsusaka General Hospital
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- NAKANO Hiroshi
- Department of Clinical Pathology, Saiseikai-Matsusaka General Hospital
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- KOSAKA Toshiya
- Department of Surgery, Tsu Seikyo Hospital
Bibliographic Information
- Other Title
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- 視力低下にて発症した胃癌術後髄膜癌腫症の1例
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Abstract
<p>A 78-year-old woman had undergone total gastrectomy and chemotherapy for gastric cancer (pT4N3bM0 Stage IIIC, poorly differentiated adenocarcinoma). She received S-1 monotherapy 3 times weekly (S-1 at 80mg twice daily for 14 days, every 3 weeks). She underwent routine examinations, including tumor markers and computed tomography. She had no signs of recurrent disease, but she suffered from a loss of eyesight 2 years and 8 months after the operation. A choked disc was found, but she had no headaches, nausea, or unconsciousness, which indicated high intraventricular pressure. Enhanced T2-weighted magnetic resonance imaging showed high intensity around the optic nerve. We performed cerebrospinal fluid cytological analysis, which showed poorly differentiated adenocarcinoma. She was diagnosed as having leptomeningeal carcinomatosis of gastric cancer. The patient chose best supportive care and died 2 months after symptoms appearance. Histological analysis during the autopsy showed moderately to poorly differentiated adenocarcinoma. The carcinoma had also infiltrated the spinal cord, peritoneum, and adrenal glands. Histologically, the carcinoma had infiltrated the optic nerve, which caused loss of eyesight. We have not yet established effective therapies for leptomeningeal carcinomatosis, and the prognosis is poor. Leptomeningeal carcinomatosis of gastric cancer that appears by loss of eyesight is very rare. This case illustrates that the possibility of leptomeningeal carcinomatosis should be considered when we treat patients with loss of eyesight of an unknown cause after surgery.</p>
Journal
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- Nippon Shokakibyo Gakkai Zasshi
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Nippon Shokakibyo Gakkai Zasshi 115 (8), 755-759, 2018-08-10
The Japanese Society of Gastroenterology