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Carcinoid carcinomatous meningitis.

R A Nagourney, R Hedaya, M Linnoila

Annals of Internal Medicine

|June 1, 1985

Summary

This summary is machine-generated.

Carcinoid tumors can cause carcinomatous meningitis, leading to neurological symptoms. Elevated serotonin and 5-HIAA in cerebrospinal fluid confirmed this rare complication in a patient with metastatic carcinoid tumor.

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Area of Science:

Neuro-oncology
Endocrinology
Oncology

Background:

Metastatic carcinoid tumors are rare neuroendocrine neoplasms.
Neurological complications can arise from metastatic disease, but are infrequently documented.
Carcinoid syndrome is characterized by excess hormone secretion, typically serotonin.

Observation:

A 67-year-old woman presented with left facial paralysis and progressive lower extremity weakness.
Cerebrospinal fluid cytology was unremarkable.
Cerebrospinal fluid biochemical analysis revealed markedly elevated 5-hydroxyindoleacetic acid (5-HIAA) and serotonin levels.

Findings:

Biochemical findings in cerebrospinal fluid strongly suggested carcinomatous meningitis secondary to metastatic carcinoid tumor.
Contrast myelography confirmed the presence of meningeal metastases.
The patient's neurological deficits were attributed to leptomeningeal carcinoid involvement.

Implications:

This case highlights the importance of biochemical analysis of cerebrospinal fluid in diagnosing rare neurological complications of carcinoid tumors.
Elevated 5-HIAA and serotonin in CSF can be a critical diagnostic marker for carcinomatous meningitis in the appropriate clinical context.
Early recognition and diagnosis of meningeal metastases are crucial for timely management and potentially improving patient outcomes.