Hepatitis B Virus (HBV)

Category: Leptomeningeal carcinomatosis

Endoscopic view of the lower esophagus and the gastroesophageal junction

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: CASE PRESENTATION Part 1

A 50-year-old, male construction worker presented with a two-month history of progressive solid food dysphagia accompanied by a 3 kg weight loss. He had no history of gastroesophageal reflux disease, caustic ingestion or scleroderma. He was a cigarette smoker of half a pack per day for at least 30 years and had been drinking one […]

Leptomeningeal carcinomatosis

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: DISCUSSION Part 4

In a review of 334 esophagectomies performed in the authors’ centre and 293 additional cases from surgical pathology files, Gabrielsen et al found brain metastases in about 3.6% of cases. There was an increased tendency of CNS involvement, with large primary neoplasm, adenocarcinoma of the gastroesophageal junction, or findings of local invasion and lymph node […]

Leptomeningeal carcinomatosis

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: DISCUSSION Part 3

Early recognition andtreatment of LC will not reverse fixed neurological deficits, but may improve general neurological status and prolong survival. Although not shown in randomized and prospective studies, it has been suggested that all patients with overt LC should be offeredtreatment except those patients with widespread and uncontrolled systemic neoplasia. Standard therapy for LC is […]

Leptomeningeal carcinomatosis

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: DISCUSSION Part 2

The diagnosis of LC requires a high index of suspicion. CSF examination is the most valuable test. It should be performed in any patient with unexplained altered neurological status or focal neurological changes. Finding carcinoma cells in the CSF is diagnostic. Other common findings are increased opening pressure, pleocytosis and a modest elevation in the […]

Leptomeningeal carcinomatosis

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: DISCUSSION Part 1

LC is a rare complication of metastatic cancer. It has been reported most commonly in adenocarcinomas of solid organs. Approximately 5% of all patients with breast cancer, 9% to 25% of patients with small cell lung cancer and 23% of patients with melanoma will develop LC. Of tumours from the gastrointestinal tract, it has been […]

Computed tomogram of the brain

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: CASE PRESENTATION Part 3

The patient’s dysphagia progressed rapidly. He was admitted to the hospital because of marked difficulty swallowing liquids and solids, which resulted in volume depletion and malnutrition. At that time he complained of extreme fatigue and a new symptom of mild occipital headache. There was no associated nausea, vomiting or visual disturbances. His level of consciousness […]

Computed tomography of the chest

Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: CASE PRESENTATION Part 2

Computed tomography (CT) demonstrated an area of severe circumferential thickening involving the distal 6 cm of the esophagus, extending to the gastroesophageal junction (Figure 2). No regional sym-phadenopathy was noted. The lungs and liver were clear of metastases. Endoscopic ultrasound of the tumour confirmed the extension of the mass beyond the muscularis mucosa margin at […]

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