Lung Adenocarcinoma-Induced Leptomeningeal Metastasis Complicated by Lemierre Syndrome
Overview
This report details a rare case of Lemierre syndrome (LS) occurring concurrently with lung adenocarcinoma (LADC) that progressed to leptomeningeal metastasis (LM). The case highlights the diagnostic challenges and clinical implications of managing these complex conditions.
Background
Lemierre syndrome is a rare but serious condition often misdiagnosed due to its low incidence and overlapping symptoms with other diseases. Lung adenocarcinoma is a leading cause of cancer-related mortality, with a significant proportion of patients developing metastasis, including LM. The co-occurrence of LS and LADC-related LM is extremely rare, necessitating increased clinical awareness and vigilance.
Data Highlights
Test
Result
Blood Glucose
9.3 mmol/L
HbA1c
6.5%
CRP
54.3 mg/L
D-dimer
4.83 mg/L
Fibrinogen
5.62 g/L
Key Findings
Lemierre syndrome is characterized by oropharyngeal infection, internal jugular vein thrombosis, and anaerobic pathogens, primarily Fusobacterium necrophorum.
Approximately 30-40% of patients with advanced lung adenocarcinoma develop leptomeningeal metastasis.
The patient presented with pleuritic chest pain and was later diagnosed with both LS and LADC with LM.
Diagnostic imaging revealed thrombosis in the jugular veins and pulmonary arterial thrombosis consistent with septic emboli.
This case is the first reported instance of concurrent Lemierre syndrome and EGFR-mutant lung adenocarcinoma leading to leptomeningeal metastasis.
Clinical Implications
Healthcare professionals should maintain a high index of suspicion for Lemierre syndrome in patients presenting with oropharyngeal infections and neck pain, especially in the context of lung cancer. Early diagnosis and targeted treatment are crucial to prevent severe complications associated with both conditions.
Conclusion
This case underscores the importance of recognizing the rare co-occurrence of Lemierre syndrome and lung adenocarcinoma-related leptomeningeal metastasis, highlighting the need for thorough diagnostic evaluation and timely intervention.
Researchers from Roswell Park Comprehensive Cancer Center will report their latest findings to colleagues from around the world at the 2025 annual meeting of the American Association for Cancer Research (AACR) in Chicago, Illinois, April 25-30.
