Year 2017 / Volume 109 / Number 7
Letter to the Editor
Leptomeningeal carcinomatosis in a young patient with obstructive colorectal signet- ring cell adenocarcinoma

535

DOI: 10.17235/reed.2017.4602/2016

Alejandro Lusilla, Jorge de Tomás,

Abstract
We present the case report of a twenty-five-year-old Moroccan male patient who suffered from leptomeningeal carcinomatosis related to a signet-ring cell carcinoma of the rectum. He presented to the emergency department with abdominal pain, constipation, weight loss and rectal bleeding. The rectal examination showed a rectal tumor and a CT scan revealed a large bowel obstruction due to rectal diffuse thickening. An emergency transverse colostomy was performed, with a rectal biopsy and a cytological sample collection. The pathology analysis showed a signet-ring cell carcinoma from the rectum. The staging evaluation was completed and neoadjuvant chemotherapy and radiotherapy were offered to the patient. Two months later, he developed neurological signs of leptomeningeal involvement which was confirmed by a lumbar puncture. Then, the patient received systemic and intrathecal chemotherapy but later died. This case shows the tendency of colorectal signet-ring cell carcinomas to cause leptomeningeal metastasis, even in young patients.
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References
1. Assi R, Hamieh L, Mukherji D, et al. Leptomeningeal metastasis as initial manifestation of signet ring colorectal adenocarcinoma: a case report with review of literature. J Gastrointest Oncol 2015;6:E89-E101.
2. Ohkawa H, Nakazawa k, Nakada K, et al. Carcinoma of the colon associated with diffuse metastatic leptomeningeal carcinomatosis (DMLC) presenting as disturbance of consciousness-a case report. Gan No Rinsho 1984;30:409-12.
3. Kleinfeld K, Peters WH, Stephenson C, et al. Leptomeningeal metastasis from occult signet-ring cell colon adenocarcinoma presenting with isolated headache. J Clin Neurosci 2013;20:890-2.
4. Mohebi N, Moghaddasi M, Karimian H. Diffuse leptomeningeal metastasis from signet-ring cell adenocarcinoma of the sigmoid. JCRP 2014;2:34-6.
5. Nagashima M, Sugishita Y, Moriyama A, et al. Tumor-like growth of giant inflammatory polyposis in a patient with ulcerative colitis. Case Rep Gastroenterol 2013;7:352-7.
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Lusilla A, de Tomás J. Leptomeningeal carcinomatosis in a young patient with obstructive colorectal signet- ring cell adenocarcinoma. 4602/2016


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Publication history

Received: 06/09/2016

Accepted: 22/12/2016

Online First: 22/05/2017

Published: 30/06/2017

Article revision time: 103 days

Article Online First time: 258 days

Article editing time: 297 days


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