To report a case of leptomeningeal metastasis from gastric cancer presenting with hearing impairment, dizziness, and gait instability.
Approach:
Patient Presentation: A 71-year-old man with gastric cardia adenocarcinoma developed hearing impairment, dizziness, and gait instability approximately 11 months after radical total gastrectomy.
Key Findings:
Leptomeningeal metastasis from gastric cancer can present with hearing impairment and other atypical neurological symptoms.
CSF cytology may be negative despite the presence of leptomeningeal metastasis.
MRI findings, CSF biochemistry, and clinical assessment are crucial for diagnosis.
Interpretation:
This case illustrates the diagnostic challenges of leptomeningeal metastasis due to nonspecific symptoms and negative CSF cytology.
Limitations:
The case is based on a single patient, which limits the generalizability of the findings.
No imaging was performed during the chemotherapy period, which may have provided additional insights.
Conclusion:
Integrated assessment of clinical, imaging, and CSF findings is essential for diagnosing leptomeningeal metastasis in gastric cancer.
