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- W2978003721 abstract "Leptomeningeal carcinomatosis is defined as a dissemination of tumor cells throughout the meninges and ventricles. It is a rare manifestation of gastrointestinal cancers. Rarely, gallbladder cancers can metastasis to the meninges. We describe a patient with leptomeningeal carcinomatosis as the initial manifestation of gallbladder cancer. Case description: An 81 year-old Caucasian female with past medical history significant for hypertension and coronary artery disease who presented to the emergency department with intractable headache, vomiting, and ataxia of gait of 2 weeks duration. A plan CT scan of brain was normal. Esophagogastroduodenoscopy was normal with intact mucosa and peristalsis; multiple jumbo biopsies of stomach were negative for malignancy. CT Scan of abdomen and pelvis with contrast revealed asymmetric thickening of gallbladder's wall, and lytic lesion of lumbar vertebral body L12, no hepatic of pancreatic lesions were seen. Ultrasound of gallbladder showed cholelithiasis and confirmed an asymmetric thickening of the gallbladder's wall. CT – guided biopsy of the spinal lesion revealed signet-ring cell adenocarcinoma with mucinous features. Immunoperoxidase stain was positive for CA19–9, positive for CK7, weak positive for CK20, and negative for TTF, consistent with pancreatic-biliary cancer. Serum CA 19–9 was 9295 U/ml (normal level less than 37 U/ml). Serum CEA level was within normal limit. MRI of brain without and with contrast showed abnormal enhancement along the cerebellum and cerebellar vermis suggesting of leptomeningeal carcinomatosis. Patient refused any further workup or treatment and went for hospice. Discussion: Gallbladder cancer (GBC) is an uncommon and highly fatal malignancy. Majority of GBC cases are found incidentally in patients undergoing exploration for cholelithiasis. Leptomeningeal carcinomatosis can rarely be the initial manifestation of GBC. In the present case, the occult GBC metastasized directly to the meninges without evidence of involvement of the liver or pancreas. This is one of the very few reported cases manifesting as such in the medical literature." @default.
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- W2978003721 date "2006-09-01" @default.
- W2978003721 modified "2023-09-26" @default.
- W2978003721 title "Gallbladder Cancer Presenting as Leptomeningeal Carcinomatosis" @default.
- W2978003721 doi "https://doi.org/10.14309/00000434-200609001-00721" @default.
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