Carcinomatous Meningitis from Asymptomatic Signet-Ring Carcinoma of the Stomach: a Case Report

Abstract

Abstract: Signet-ring cell carcinoma of the stomach is a fairly common malignant tumor in Thailand with marked variation of clinical presentation. I described a 37 year old female whose first manifestation was only neurologic symptoms compatible with carcinomatous meningitis. CT scan and MRI brain were normal. CSF cytology showed atypical cells with some degree of degeneration suggestive of malignancy. Postmortem examination of the patient revealed diffuse leptomeningeal infiltration by signet-ring adenocarcinoma and signet-ring adenocarcinoma of the stomach. The neoplasm also metastasized to regional lymph nodes, both ovaries, uterus and myocardium of right ventricle. The cause of death was lobar pneumonia of both lungs. This case is an unusual manifestation of carcinoma of the stomach resulting from carcinomatous meningitis. This is the first reported case in the last 9 years at Maharat Nakhon Ratchasima Hospital.