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Leptomeningeal carcinomatosis presenting as eosinophilic meningitis
Abstract:
The case of a 67-year-old man with underlying carcinomatous meningitis who presented with meningismus and cerebrospinal fluid (CSF) eosinophilia is reported. CSF eosinophilia can reflect a number of underlying conditions; however, carcinomatous meningitis is not generally considered. In this case, studies for bacterial, fungal and parasitic agents were negative. Cytologic examination of a lumbar puncture specimen revealed malignant epithelial cells in an inflammatory background. When unexplained eosinophilia is found in the CSF, a thorough search for coincident meningeal carcinomatosis should be undertaken.
Insights
Carcinomatous meningitis, a form of cancer affecting the brain and spinal cord lining, can cause cerebrospinal fluid (CSF) eosinophilia. This case highlights the importance of considering cancer when CSF eosinophilia is unexplained.
Area of Science:
- Neuro-oncology
- Neurology
- Clinical pathology
Background:
- Cerebrospinal fluid (CSF) eosinophilia is an uncommon finding.
- It can be associated with various conditions, including infections and inflammatory disorders.
- Meningeal carcinomatosis is not typically considered a cause of CSF eosinophilia.
Observation:
- A 67-year-old man presented with meningismus and CSF eosinophilia.
- Extensive testing for bacterial, fungal, and parasitic infections was negative.
- Cytologic examination of CSF revealed malignant epithelial cells.
Findings:
- The patient was diagnosed with carcinomatous meningitis.
- This case demonstrates a rare presentation of meningeal carcinomatosis.
- Unexplained CSF eosinophilia prompted the investigation for malignancy.
Implications:
- Clinicians should consider carcinomatous meningitis in the differential diagnosis of unexplained CSF eosinophilia.
- Early detection of meningeal carcinomatosis is crucial for timely treatment.
- This finding underscores the need for comprehensive diagnostic evaluation in neurological cases.