Leptomeningeal carcinomatosis in a patient with PALB2-mutated pancreatic adenocarcinoma: A case report and review of the literature

Pancreatic cancer remains an inauspicious malignancy with poor long-term outcomes. The majority of patients present with advanced disease; many suffer from consequences of local progression of disease, and survival rates remain unacceptably poor. Central nervous system (CNS) metastatic spread is uncommon, with leptomeningeal carcinomatosis or leptomeningeal disease (LMD) having seldom been described in the literature. Herein we report the case of a patient with metastatic PALB2-mutated pancreatic cancer who developed progressive neurologic symptoms from LMD after five years of treatment. This case and others suggest a possible link between pancreatic cancer with absent double-strand break DNA homologous recombination repair mechanisms and the development of leptomeningeal disease.