No Intraparenchymal Mass Lesion in a Patient with Lung Adenocarcinoma with Treatment-Resistant Seizures: What Next?/Tedaviye Direncli Nobetlerden Muzdarip Akciger Adenokarsinomlu Bir Hastada Intraparankimal Kitle Lezyonu Yok: Ne Yapmali?

Leptomeningeal carcinomatosis (LMC) is a relatively rare complication of advanced-stage cancer. The diagnosis of LMC is based on clinical and radiologic findings and cytologic examinations. The diagnosis may be difficult because the clinical findings may be subtle initially, and the specificity of t...

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Published inTürk nöroloji dergisi Vol. 27; no. 2; p. 212
Main Authors Inan, Berin, Kapakli, Gozde Elif Tasar, Dericioglu, Nese
Format Journal Article
LanguageEnglish
Published Galenos Yayinevi Tic. Ltd 01.06.2021
Subjects
Case studies
Central nervous system diseases
Complications and side effects
Lung cancer
Metastasis
Seizures (Medicine)
Turkey
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Summary:Leptomeningeal carcinomatosis (LMC) is a relatively rare complication of advanced-stage cancer. The diagnosis of LMC is based on clinical and radiologic findings and cytologic examinations. The diagnosis may be difficult because the clinical findings may be subtle initially, and the specificity of the diagnostic modalities is low. A 41-year-old male patient with metastatic lung adenocarcinoma presented with headache, confusion, and treatment-resistant seizures. There was no intraparenchymal mass lesion or leptomeningeal contrast enhancement in brain magnetic resonance imaging. The presence of LMC was demonstrated in a cytopathologic examination of cerebrospinal fluid. The seizures were controlled with antiepileptic treatment, but the patient was referred to the palliative care center due to poor oncologic prognosis. Keywords: Leptomeningeal carcinomatosis, lung adenocarcinoma, cerebrospinal fluid cytology, possible non-convulsive status epilepticus Leptomeningeal karsinomatozis (LMK), ileri evre kanserlerin gorece nadir bir komplikasyonudur. Bu tani klinik ve radyolojik bulgular ile sitolojik incelemelere dayanarak koyulur. Klinik bulgularin baslangicta silik olabilmesi ve tani modalitelerinin spesifisitesinin dusuk olmasi nedeniyle tani koymada gucluk yasanabilir. Metastatik akciger adenokarsinomlu, 41 yasinda bir erkek hasta bas agrisi, konfuzyon ve tedaviye direncli nobetlerle basvurdu. Beyin manyetik rezonans goruntulemesinde intraparankimal kitle lezyonu ya da leptomeningeal kontrast tutulumu saptanmadi. Beyin omurilik sivisinin sitopatolojik incelemesi ile LMK varligi gosterildi. Antiepileptik tedavi ile nobetleri kontrol altina alindi ancak onkolojik prognozunun kotu olmasi nedeniyle hasta, palyatif bakim merkezine sevk edildi. Anahtar Kelimeler: Leptomeningeal karsinomatozis, akciger adenokarsinomu, beyin omurilik sivisi sitolojisi, olasi non-konvulsif status epileptikus
ISSN:1301-062X
1309-2545
DOI:10.4274/tnd.2021.94762