Leptomeningeal carcinomatosis in advanced esophageal adenocarcinoma: A case report on presentation and diagnosis.

Int J Surg Case Rep

Northeast Georgia Health System Inc, Trauma and Acute Care Surgery Department, 743 Spring Street NE, Gainesville, GA 30501, United States of America. Electronic address:

Published: December 2024

AI Article Synopsis

  • Leptomeningeal carcinomatosis (LC) is a serious complication of advanced esophageal adenocarcinoma, with a poor prognosis despite aggressive treatment.
  • A 64-year-old male with esophageal adenocarcinoma developed neurological symptoms indicative of LC after undergoing multiple treatments; MRI and cerebrospinal fluid analysis confirmed the diagnosis.
  • The focus of management shifted to palliative care due to rapid deterioration, highlighting the need for early detection and intervention in such cases, as effective therapies for LC are still limited.

Article Abstract

Introduction And Importance: Leptomeningeal carcinomatosis (LC) is an uncommon but severe complication of advanced esophageal adenocarcinoma. Typically diagnosed through MRI and cerebrospinal fluid analysis, LC carries a poor prognosis despite aggressive management.

Case Presentation: A 64-year-old male with a history of coronary artery disease, diabetes, and other comorbidities presented with progressive dysphagia. Diagnostic imaging and biopsy confirmed esophageal adenocarcinoma with local invasion and distant metastases, including mediastinal lymphadenopathy. Despite treatment with chemotherapy, radiation, and surgical interventions such as jejunostomy tube placement, the patient developed neurological symptoms suggestive of LC. MRI confirmed leptomeningeal involvement, and cerebrospinal fluid analysis revealed malignant cells.

Clinical Discussion: Management focused on palliative care, including chemotherapy and radiation. The patient's condition deteriorated rapidly, consistent with the poor prognosis associated with LC in esophageal cancer.

Conclusion: This case discusses the importance of early detection and intervention in managing esophageal adenocarcinoma, particularly when neurological symptoms suggest central nervous system involvement. Despite advances in cancer treatment, LC remains a difficult condition to manage, with limited effective therapeutic options.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667075PMC
http://dx.doi.org/10.1016/j.ijscr.2024.110708DOI Listing

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