Effect of occupational therapy for delirium patient with carcinomatous meningitis of lung cancer

<b>Purpose: </b>A report of effective occupational therapy for delirium patients with cancer is uncommon. We report a patient of carcinomatous meningitis, in whom her daily activity is improved by occupational therapy. <b>Case: </b>Firstly, we supported her meals and then started occupational therapy accepting her interest. Although degree of confusion and her performance status was not varied from beginning to end, she could concentrate our programmed works and change her way of feelings. Also occupational therapy promotes reminiscence about her life review and friendship among other patients even in delirium condition. <b>Conclusion: </b>Occupational therapy can reduce cancer patients' impatience, anxiety and solitary feelings and improve quality of life.

Leptomeningeal Carcinomatosis of Gastric Cancer Misdiagnosed as Vestibular Schwannoma

Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when treating patients with gastric cancer.

Collecting duct renal cell carcinoma with the syndrome of inappropriate antidiuresis: An autopsy case report.

A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.

Effective acetazolamide for the symptoms of increased intracranial pressure due to carcinomatous meningitis: a case report

<b>Introduction</b>: We experienced a case in which acetazolamide proved to be effective for the symptoms of increased intracranial pressure due to carcinomatous meningitis. <b>Case</b>: The patient was a male in his fifties who was diagnosed lung adenocarcinoma. He was suffered from headache and vomiting due to carcinomatous meningitis after his admission to our palliative care unit, so he was prescribed steroids and a glycerin infusion. But only morning headache remained, and we added acetazolamide 500 mg per day and his morning headache improved. <b>Conclusion</b>: This morning headache is thought to reflect exacerbation of raised intracranial pressure through nocturnal hypoventilation with a rise in PaCO2, so it was thought that acetazolamide decreased PaCO2 and relieved morning headache.

A case of carcinomatous meningitis: therapy and symptom management using an intrathecal catheter with subcutaneous port

In general, intrathecal opioid administration is considered for intractable cancer pain management. We would like to report a case of carcinomatous meningitis that was successfully treated by using an intrathecal catheter with subcutaneous port. A female in her fifties with carcinomatous meningitis secondary to invasive ductal breast cancer was suffering multiple neurological symptoms including headache. Intrathecal catheterization with subcutaneous port was considered as an alternative to Ommaya reservoir placement to continue intrathecal antineoplastic treatment. The port was used for collection of CSF, antineoplastic drug administration and opioid delivery. Neoplastic cells in the CSF disappeared within one month and the headache and other neurological symptoms improved. The patient died five months post diagnosis (four months after initiation treatment via intrathecal catheter) without recurrence of significant headache, before developing coma seven days prior to death. This case suggests an intrathecal catheter with subcutaneous port may be used effectively for both symptom management and the administration of antineoplastic drugs. However, further study is necessary.