A Rare Case of Unknown Primary with First Presentation of Leptomeningeal Dissemination: Case Approach and Literature Review

Leptomeningeal dissemination (LM) is a major complication of a systemic cancer. In this paper, we will present a rare case of LM as the first presenting feature of an unknown primary. The patient had a good response to systemic corticosteroids for a week but, surprisingly, after investigation, the primary tumor was suspected to be a gastric tumor. Sadly, the patient died a few days later. In a literature search, it was hard to find similar cases, and the suggested protocols are very vague about LM from an unknown tumor. This case demonstrates that LM can be the first presentation of a systemic tumor, raising questions on treatment with corticosteroids.