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- W4225845138 abstract "A 48-year-old man visited our hospital complaining of abdominal pain constipation and mucous bloody stool. He was diagnosed rectal cancer with remarkable local infiltration in the pelvic organs and no distant metastasis. The pathological diagnosis was poorly differentiated adenocarcinoma and signet ring cell carcinoma. He was administered neoadjuvant chemoradiotherapy(45 Gy/30 Fr, S-1 100 mg/day 2-weeks administration, 1-week withdrawal)and underwent abdominal perineal rectal amputation. No cancer cells remained in the excised organs, so he was diagnosed with pathologic complete response(pCR). The serum CEA level decreased from 35.1 to 5.9 ng/mL at this point. Due to recurrence of peritoneal dissemination during postoperative adjuvant chemotherapy(CapeOX), the regimen was changed to FOLFIRI plus Pmab. After 4 courses of FOLFIRI plus Pmab, he complained dizziness and headache. Therefore, head computed tomography and magnetic resonance imaging were performed. However, there were no abnormal findings. An evaluation of his cerebrospinal fluid resulted in a diagnosis of meningeal carcinomatosis by fluid cytology(adenocarcinoma/class Ⅴ). His medical condition worsened rapidly and he ultimately died 2.5 months after the onset of his headache. The serum CEA level ultimately reached 2,992.6 ng/mL. The patient had been deemed to have pCR following the administration of neoadjuvant chemoradiation and surgery. His serum CEA level had increased continuously during the early period of postoperative chemotherapy without any abdominal imaging or neurological findings. After the onset of the primary symptoms of meningeal carcinomatosis, his condition deteriorated rapidly. When we encounter patients with colorectal cancer, especially those with poorly differentiated adenocarcinoma, and a continuously increasing CEA level despite no remarkable findings, we should suspect meningeal carcinomatosis and perform further examinations, including sampling the cerebrospinal fluid." @default.
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- W4225845138 date "2021-12-01" @default.
- W4225845138 modified "2023-09-30" @default.
- W4225845138 title "[A Fatal Case of Meningeal Carcinomatosis in a Rectal Cancer Patient Diagnosed with Pathologic Complete Response after Neoadjuvant Chemoradiotherapy]." @default.
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