BMJ Case Reports 2018; doi:10.1136/bcr-2018-226557
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Leptomeningeal metastases of a well-differentiated neuroendocrine tumour: a rare entity

  1. MET Tesselaar1
  1. 1Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
  2. 2Department of Neuro-Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
  3. 3Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
  1. Correspondence to JM Versluis, j.versluis{at}
  • Accepted 16 October 2018
  • Published 3 November 2018


A 73-year-old man, without any medical history, had presented with dark urine and pale stool without pain. Diagnostic imaging revealed a tumour in the pancreas with liver metastases. Histopathological examination showed a well-differentiated pancreatic neuroendocrine tumour. After a stable 2.5 years on everolimus, progression of the liver metastases was seen and a switch was made to chemotherapy. Three months later, he developed progressive spinal neurological symptoms. MRI of the spine and brain revealed leptomeningeal contrast-enhancing lesions. Cytopathological examination of the cerebrospinal fluid showed malignant epithelial cells compatible with well-differentiated neuroendocrine tumour. Epithelial cell-adhesion molecule-based flow cytometry of the cerebrospinal fluid confirmed the presence of epithelial tumour cells. Based on these results, the diagnosis of leptomeningeal metastases of an originally well-differentiated neuroendocrine tumour of the pancreas was made.


  • Contributors All authors declare to have made substantial contributions to this case report by revising the work critically for its intellectual content. The first author has written the case report and processed the comments by the other authors. Final approval of the version published is given by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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