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CASE REPORT
An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung
  1. Nadina Tinsley1,
  2. Nikitha Yemula2,
  3. Satheesh Ramalingam3,
  4. Shyam Madathil4
  1. 1Department of Oncology, Christie NHS Foundation Trust, Manchester, UK
  2. 2Department of Paediatrics, Heart of England NHS Foundation Trust, Birmingham, UK
  3. 3Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  4. 4Department of Respiratory, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Nadina Tinsley, nadina.tinsley{at}nhs.net

Summary

A 72-year-old man was brought to the emergency department with acute onset confusion and haemoptysis. Chest X-ray showed a possible lung mass, while CT head showed a fluid-filled, space-occupying lesion (SOL) in the right frontal lobe of the brain. MRI head indicated that this SOL had spilt its contents into the subarachnoid and intraventricular spaces. Due to a fluctuating Glasgow Coma Scale (GCS), the patient underwent emergency debulking. Macroscopically, a frail-walled cystic tumour filled with straw-coloured fluid was noted; histology confirmed metastasis from a primary lung adenocarcinoma. Whole brain radiotherapy was given, with a view to commence systemic therapy. The patient, however, deteriorated and unfortunately passed away a few weeks after completing radiotherapy. This patient presented with leptomeningeal metastasis as the first presentation of a lung adenocarcinoma, and had a highly unusual mechanism by which leptomeningeal spread had occurred, with metastatic brain tumour spilling its contents into the meningeal spaces.

  • respiratory cancer
  • lung cancer (oncology)
  • neurooncology

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Footnotes

  • Contributors The corresponding author, NT, was responsible for the literature review and the drafting of the article. NY was responsible for writing the clinical case and drafting the article. Both NT and NY contributed equally to this paper. SR obtained and labelled the MRI images, and helped with critical revisions of the article. SM supervised the overall process and was also involved in critical revisions; he is the guarantor.

  • 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 Obtained.

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

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