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[Leptomeningeal metastasis. 위암 수막내 전이] - 終
Diffuse infiltration of malignant cells throughout the pia mater and arachnoid membrane
3-8% of call cancer patients (gastric cancer: 0.16-0.69%, AGC Borrmann type 3 or 4, poorly differentiated or signet ring cell carcinoma)
증상: headache, nausea, vomiting, altered mental status, seizure, spinal symptoms, weakness
진단: cytological examination of the CSF (sensitivity 54%) MRI: T1, FLAIR (flat-attenuated inversion recovery) images (비정상적인 지부막하 공간을 반영하는 sulci의 증가된 신호와 locoregional thickening이 right superior frontal sulcus에서 관찰됨, sensitivity 65-75%)
WJG 2009
CSF findings
MRI findings (左 T1, 右 FLAIR)
치료: IT chemotherapy, RT, VP shunt, best supportive care
예후는 매우 나쁩니다.
WJG 2009
AGC with leptomeningeal seeding은 흔히 있는 일이 아니므로 종종 case report되고 있습니다. (JDCR 2016)
[References]
1) Leptomeningeal carcinomatosis in gastric cancer Arch Clin Cases 2022
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.
