Leptomeningeal carcinomatosis in gastric cancer: a case report of a rare yet aggressive entity

Mafalda Miranda Baleiras, Joana Graca, Leonor Fernandes, Martinha Chorao, Ana Carolina Vasques, Marta Mesquita Pinto

Abstract


Leptomeningeal carcinomatosis (LMC) is exceedingly rare in gastric cancer. It is most commonly seen in breast, lung cancer and melanoma, and is associated with an extremely poor prognosis. If untreated, median overall survival is four to six weeks. No standard treatment for LMC exists and published data are scarce. We present two cases of gastric carcinoma diagnosed with LMC that exemplify how aggressive this condition is and how short the time lapse is to perform any targeted therapy. This report aims to raise awareness of this rare metastatic possibility in gastric cancer and its diagnostic and therapeutic challenges.

Keywords


leptomeningeal carcinomatosis; gastric cancer; advanced cancer; intrathecal chemotherapy

Full Text:

PDF

References


Kim NH, Kim JH, Chin HM, Jun KH. Leptomeningeal carcinomatosis from gastric cancer: single institute retrospective analysis of 9 cases. Ann Surg Treat Res. 2014; 86(1):16-21.

Pentheroudakis G, Pavlidis N. Management of leptomeningeal malignancy. Expert Opin Pharmacother. 2005; 6:1115-1125.

Kim M. Intracranial involvement by metastatic advanced gastric carcinoma. J Neurooncol. 1999; 43(1):59-62.

Le Rhun E, Weller M, Brandsma D, et al. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours. Ann Oncol. 2017; 28(Suppl. 4):iv84–iv99.

Kwon J, Chie EK, Kim K, et al. Impact of multimodality approach for patients with leptomeningeal metastases from solid tumors. J Korean Med Sci. 2014; 29(8):1094–1101.

Kountourakis P, Papamichael D, Haralambous H, et al. Leptomeningeal metastases originated from esophagogastric junction/gastric cancer: A brief report of two cases. World J Gastrointest Oncol. 2018; 10(1):56-61.

Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006; 355:11-20.

Giglio P, Weinberg JS, Forman AD, Wolff R, D Groves M. Neoplastic meningitis in patients with adenocarcinoma of the gastrointestinal tract. Cancer. 2005; 103:2355-2362.

Liu Y. Leptomeningeal carcinomatosis from gastric cancer successfully treated by the intrathecal methotrexate plus temozolomide and simultaneous radiotherapy: Case report and literatures review. Cancer Biol Ther. 2017; 18(10):761-764.

Park KK, Yang SI, Seo KW, Kim YO, Yoon KY. A case of metastatic leptomeningeal carcinomatosis from early gastric carcinoma. World J Surg Oncol. 2012; 10:74.

Chowdhary S, Chamberlain M. Leptomeningeal metastases: Current Concepts and Management Guidelines. JNCCN. 2005; 3(5).

Chamberlain MC. Leptomeningeal metastasis. Current Opin Oncol. 2010; 22(6):627-635.

Groves MD. New strategies in the management of leptomeningeal metastases. Arch Neurol. 2010; 67(3):305-312.

Beauchesne P. Intrathecal chemotherapy for treatment of leptomeningeal dissemination of metastatic tumours. Lancet Oncol. 2010; 11:871-879.

Lassman AB, Abrey LE, Shah GD, et al. Systemic high-dose intravenous methotrexate for central nervous system metastases. J Neurooncol. 2006; 78:255-260. Erratum in: J Neurooncol. 2006; 78(3):261. Shah, Gaurav G [corrected to Shah, Gaurav D].

Kak M, Nanda R, Ramsdale EE, Lukas RV. Treatment of leptomeningeal carcinomatosis: current challenges and future opportunities. J Clin Neurosci. 2015; 22(4):632-637.

Fakih M, Schiff D, Erlich R. Intramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: A series of six cases. Ann Oncol. 2001; 12(8):1173–1177.

Lee SH, Kong DS, Seol HJ, Nam DH, Lee JI. Ventriculoperitoneal shunt for hydrocephalus caused by central nervous system metastasis. J Neurooncol. 2011; 104:545-551.

Mir O, Ropert S, Alexandre J, Lemare F, Goldwasser F. High-dose intrathecal trastuzumab for leptomeningeal metastases secondary to HER-2 overexpressing breast cancer. Ann Oncol. 2008; 19:1978-1980.

Satoh T, Xu RH, Chung HC, et al. Lapatinib plus paclitaxel versus paclitaxel alone in the second-line treatment of HER2-amplified advanced gastric cancer in Asian populations: TyTAN--a randomized, phase III study. J Clin Oncol. 2014; 32:2039-2049.

Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010; 376:687-697. Erratum in: Lancet. 2010; 376(9749):1302.




DOI: http://dx.doi.org/10.22551/2022.34.0901.10196

Copyright (c) 2022 Mafalda Miranda Baleiras, Joana Graca, Leonor Fernandes, Martinha Chorao, Ana Carolina Vasques, Marta Mesquita Pinto

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

ISSN: 2360-6975