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Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department
Derek R Cooney1, Norma L Cooney
1Department of Emergency Medicine and Undersea and Hyperbaric Medicine, SUNY Upstate Medical University, EMSTAT Center/550 East Genesee, Syracuse, New York 13202, USA. cooneyd@upstate.edu.
Abstract:
A 70-year-old female presented to the emergency department with a 3-day history of intermittent dysphasia and right facial droop. Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained, and the patient was found to have meningeal carcinomatosis, also known as leptomeningeal metastases. Meningeal carcinomatosis is a rare metastatic complication of some solid tumors and hematopoietic neoplasms, and has a median survival rate of 2.4 months. The role of the emergency physician is to appropriately diagnose this condition, treat emergent side effects, provide symptomatic relief, and ensure multi-disciplinary management.
Insights
Meningeal carcinomatosis, a rare cancer spread to the brain lining, presents with symptoms like difficulty speaking and facial drooping. Early diagnosis and multidisciplinary care are crucial for managing this condition.
Area of Science:
- Neurology
- Oncology
- Emergency Medicine
Background:
- Meningeal carcinomatosis (leptomeningeal metastases) is a rare complication of advanced cancers.
- It presents with diverse neurological symptoms, often mimicking other emergent conditions.
Purpose of the Study:
- To highlight the diagnostic challenges and emergent management of meningeal carcinomatosis in the emergency department.
- To emphasize the critical role of emergency physicians in identifying and initiating care for this rare diagnosis.
Main Methods:
- Case presentation of a 70-year-old female with new-onset neurological deficits.
- Diagnostic imaging including computed tomography (CT) and magnetic resonance imaging (MRI).
Main Results:
- Imaging revealed meningeal carcinomatosis (leptomeningeal metastases).
- The patient presented with intermittent dysphasia and right facial droop.
Conclusions:
- Meningeal carcinomatosis requires prompt diagnosis and management in the emergency setting.
- Effective treatment involves addressing emergent complications and coordinating multidisciplinary care.
