ABSTRACT
BACKGROUND: Leptomeningeal carcinomatosis is a rare complication of solid tumors, e. g., breast, lung and gastrointestinal carcinomas. Clinical manifestations are variable with radicular pains with or without neurologic deficiencies as well as headache and hallucinations. CASE REPORT: The rare case of a 57-year-old patient with neurologic symptoms caused by a leptomeningeal carcinomatosis and a spinal metastasis of an asymptomatic signet-ring cell gastric carcinoma is reported. In spite of combined radiochemotherapy the patient died already 4 weeks after discharge from hospital due to an intracerebral hemorrhage. CONCLUSION: Until today, prognosis of leptomeningeal carcinomatosis is poor with a median survival between 3-4 months independently of the primary tumor.
Subject(s)
Carcinoma, Signet Ring Cell/secondary , Meningeal Neoplasms/secondary , Spinal Cord Neoplasms/secondary , Stomach Neoplasms/diagnosis , Biopsy , Carcinoma, Signet Ring Cell/diagnosis , Carcinoma, Signet Ring Cell/pathology , Carcinoma, Signet Ring Cell/therapy , Diagnosis, Differential , Disease Progression , Gastroscopy , Humans , Lumbar Vertebrae , Lymphatic Metastasis , Magnetic Resonance Imaging , Male , Meningeal Neoplasms/diagnosis , Meningeal Neoplasms/pathology , Meningeal Neoplasms/therapy , Middle Aged , Neoplasm Staging , Neurologic Examination , Polyradiculopathy/diagnosis , Polyradiculopathy/etiology , Sacrum , Spinal Cord Neoplasms/diagnosis , Spinal Cord Neoplasms/pathology , Spinal Cord Neoplasms/therapy , Stomach/pathology , Stomach Neoplasms/pathology , Stomach Neoplasms/therapyABSTRACT
The systemic capillary leak syndrome (SCLS), also known as Clarkson's disease, is a rare disorder characterized by paroxysmal capillary hyperpermeability with a shift of plasma fluid from the intravascular to the interstitial space. A 35-year-old previously healthy woman was admitted with rapidly developing hypovolemic shock syndrome, rhabdomyolysis, and diffuse edema. Laboratory analysis revealed a severe hemoconcentration, renal insufficiency, and paraproteinemia. After exclusion of infection, allergy, burning or drug-induced conditions, the clinical presentation was consistent with the diagnosis of SCLS. Though this is a rare entity, the substantial morbidity and mortality associated with it necessitate the physician's awareness in order to provide timely therapy. This report is meant to enhance awareness of SCLS.
