Leptomeningeal metastasis. 위암 수막내 전이. EndoTODAY 이준행

[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
2) Leptomeningeal carcinomatosis in gastric cancer: a single-center retrospective analysis of 86 cases 삼성서울병원의 증례를 모아 분석하였습니다. (PDF)