Clinical Report: Advanced Gastric Cancer Leading to Extensive Leptomeningeal Metastasis

Overview

This case study presents a 71-year-old man with advanced gastric cancer who developed leptomeningeal metastasis, initially presenting with hearing loss and neurological symptoms. Despite negative CSF cytology, MRI findings and CSF analysis supported the diagnosis.

Background

Leptomeningeal metastasis (LM) from gastric cancer is a rare complication that poses significant diagnostic challenges due to nonspecific symptoms and limited sensitivity of CSF cytology. Understanding the clinical presentation and diagnostic criteria is crucial.

Data Highlights

No numerical or trial data provided in the article.

Key Findings

• Leptomeningeal metastasis from gastric cancer can present with atypical neurological symptoms such as hearing impairment.
• CSF analysis may show hypoglycorrhachia and elevated protein levels, even when cytology is negative.
• Contrast-enhanced MRI can reveal extensive leptomeningeal enhancement.
• Integrated assessment of clinical, imaging, and CSF findings is essential for accurate diagnosis.

Clinical Implications

Healthcare professionals should consider leptomeningeal metastasis in patients with gastric cancer presenting with neurological symptoms, even when CSF cytology is negative.

Conclusion

This case highlights the importance of recognizing atypical presentations of leptomeningeal metastasis in gastric cancer.

Related Resources & Content

1. Gastric Cancer — Leptomeningeal Carcinomatosis Associated with Gastric Cancer: An Overview
2. Journal of Neuro-Oncology — Case Study and Literature Analysis of Primary Diffuse Leptomeningeal Glioblastoma
3. Case Series and Systematic Review of Metastatic Meningioma
4. Frontiers in Oncology — Case Report: Long-term survival with erlotinib for lung cancer with secondary leptomeningeal carcinomatosis
5. EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
6. NANO-LM: An updated scorecard for the clinical assessment of patients with leptomeningeal metastases
7. NANO-LM: An updated scorecard for the clinical assessment of patients with leptomeningeal metastases - PubMed
8. Auditory neuropathy as the first sign of leptomeningeal metastasis - ScienceDirect
9. The path to leptomeningeal metastasis | Nature Reviews Cancer
10. Leptomeningeal Metastasis: A Review of the Pathophysiology, Diagnostic Methodology, and Therapeutic Landscape - PMC
11. Quantification of cerebrospinal fluid tumor DNA in lung cancer patients with suspected leptomeningeal carcinomatosis | npj Precision Oncology
12. Added prognostic value of circulating tumor cell numbers in CSF of patients with leptomeningeal metastasis from epithelial tumors - ScienceDirect
13. Proton Craniospinal Irradiation for Leptomeningeal Metastases | Neuro-oncology | JAMA Oncology | JAMA Network
14. https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1464376/pdf
15. Genomic alterations of cerebrospinal fluid cell-free DNA in leptomeningeal metastases of gastric cancer - PMC