[Carcinomatous meningitis presenting with isolated headache]

O Outteryck1, D Berteloot, O Senechal

  • 1Service de Neurologie, Hôpital Dr Schaffner, Lens.

Revue Neurologique
|October 20, 2004
PubMed
Abstract

Insights

Diagnosing carcinomatous meningitis can be challenging due to non-specific symptoms. Magnetic Resonance Imaging (MRI) and elevated cerebrospinal fluid (CSF) tumor markers significantly aid in diagnosis.

Area of Science:

  • Neurology
  • Oncology
  • Radiology

Background:

  • Carcinomatous meningitis, a form of leptomeningeal metastasis, presents in 10% of solid cancer cases.
  • Diagnosis is often challenging due to non-specific clinical presentations and lack of suggestive context.

Observation:

  • A patient presented with progressively worsening isolated headache.
  • Initial Cranial Computerized Tomography (CT) was normal.
  • Brain Magnetic Resonance Imaging (MRI) revealed meningeal enhancement and nodular deposits.

Findings:

  • Cerebrospinal fluid (CSF) examinations showed elevated tumor markers and suspect cells.
  • Pulmonary adenocarcinoma was diagnosed during systematic follow-up.
  • Negative CSF-cytology is frequent in carcinomatous meningitis.

Implications:

  • Brain MRI and elevated CSF tumor markers are crucial for diagnosing carcinomatous meningitis.
  • Early and accurate diagnosis is vital for timely treatment and improved patient outcomes.
  • This case highlights the importance of advanced imaging and CSF analysis in suspected leptomeningeal metastasis.

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