Leptomeningeal carcinomatosis from gallbladder cancer after curative resection: A case report and review of literature

IF 0.2 4区医学 Q4 SURGERY International surgery Pub Date : 2021-03-08 DOI:10.9738/INTSURG-D-21-00006.1

Masashi Okawa, J. Kadono, Iwao Kitazono, S. Motoi, K. Gejima, M. Nakajo, Y. Kumagae, M. Higashi, Y. Imoto

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Abstract

Introduction Only 12 cases of gallbladder (GB) cancer associated with leptomeningeal carcinomatosis (LMC) have been reported so far. Herein, we report the first known case of LMC originating from GB cancer after curative resection and discuss the risk factors of LMC associated with GB cancer. Case Presentation An 85-year-old Japanese woman presented with vomiting and impaired awareness 2 years after curative extended cholecystectomy for GB cancer . Computed tomography showed hydronephrosis of the right kidney and ureteral thickening. Magnetic resonance imaging revealed areas of hyperintense reflecting lesions along the cerebral sulci, suggesting meningitis. A spinal tap showed an elevated cerebrospinal fluid pressure of > 270 mmH 2 O, and cytological examination of the spinal fluid revealed the presence of adenocarcinoma cells. The patient was diagnosed with retroperitoneal metastasis and LMC originating from GB cancer. The patient was given palliative care and died 4 weeks after the onset of symptoms. Conclusion The findings of this study show that LMC could occur even after curative resection of GB cancer and should be considered when patients present with neurological symptoms. Retroperitoneal metastases and poorly differentiated tumors are possible risk factors of LMC originating from GB cancer.

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癌症胆囊切除术后钩端膜癌一例报告及文献复习

引言迄今为止，仅报告12例胆囊癌症合并软脑膜癌（LMC）。在此，我们报告了第一例已知的源于GB癌症的LMC在治疗性切除后的病例，并讨论了LMC与GB癌症相关的危险因素。病例介绍一名85岁的日本妇女在治疗癌症胆囊切除术后2年出现呕吐和意识障碍。电脑断层扫描显示右肾积水及输尿管增厚。磁共振成像显示脑沟沿线有高信号反映病变，提示脑膜炎。脊髓穿刺显示脑脊液压力升高＞270 mmH 2 O，脑脊液细胞学检查显示存在腺癌细胞。患者被诊断为腹膜后转移和源于GB癌症的LMC。患者接受了姑息治疗，在症状出现4周后死亡。结论本研究结果表明，即使在癌症根治性切除后，LMC也可能发生，当患者出现神经系统症状时，应考虑LMC。腹膜后转移和低分化肿瘤可能是源于GB癌症的LMC的危险因素。

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来源期刊

International surgery 医学-外科

CiteScore

0.30

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： International Surgery is the Official Journal of the International College of Surgeons. International Surgery has been published since 1938 and has an important position in the global scientific and medical publishing field. The Journal publishes only open access manuscripts. Advantages and benefits of open access publishing in International Surgery include: -worldwide internet transmission -prompt peer reviews -timely publishing following peer review approved manuscripts -even more timely worldwide transmissions of unedited peer review approved manuscripts (“online first”) prior to having copy edited manuscripts formally published. Non-approved peer reviewed manuscript authors have the opportunity to update and improve manuscripts prior to again submitting for peer review.