A rare late leptomeningal carcinomatosis from a local advanced squamous cell laryngeal carcinoma after a long-time locoregional tumor control: case report and literature review

Abstract

Brain metastases in squamous cell carcinomas of the head and neck are extremely rare. More rarely late leptomenengeal metastases (LMMs) manifested after 10 years of laryngeal carcinoma complex treatment are diagnosed. We present a patient with a local advanced well-differentiated laryngeal carcinoma (LC) without metastases in the cervical lymph nodes/pT4 N0 M0 (G1), which was treated in 2011 by total laryngectomy and intensity modulated radiotherapy (IMRT). After 10 years, against the background of the laryngeal tumor control, two brain metastases (BMs) occur, followed by leptomeningeal carcinomatosis (LMC). Against the background of this rare clinical case and literary review, we focus on the necessary radiotherapy in late BMs, followed by leptomengial carcinomatosis. The prognosis for such distant brain incidents is extremely unfavorable. In a small number of late BMs near the ventricles, the prevention of LMC requires a whole brain radiotherapy (WBRT), followed by overdose by IMRT or radiosurgery (RS). Due to the rare cases of late cerebral and leptomenengeal metastases in head and neck squamous cell carcinomas (HNSCC), there are still no prospective studies to determine optimal complex treatment.