An Unusual Presentation of Isolated Leptomeningeal Disease in Carcinoma of Unknown Primary With Pancreatic Features
| Autor: | Madhurima Anne MD, Nazish Ahmad MD, Paul Lee MD, Mohamed Aziz MD, Yehuda Lebowicz MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Journal of Investigative Medicine High Impact Case Reports, Vol 1 (2013) |
| Druh dokumentu: | article |
| ISSN: | 2324-7096 23247096 |
| DOI: | 10.1177/2324709613494830 |
| Popis: | Leptomeningeal disease (LMD) can occur in a small percentage of patients with active metastatic cancer. However, we report a case of LMD occurring during disease remission in a patient with carcinoma of unknown primary with panreaticobiliary features. A 45-year-old woman was found with mediastinal and abdominal lymphadenopathy with lymph node biopsy consistent with adenocarcinoma, expressing immunomarkers CK7, CK20, and Ca19-9 along with markedly elevated serum Ca19-9 level. The patient was started on a pancreatic cancer directed chemotherapy regimen of Folfirinox (5-fluorouracil, leucovorin, oxaliplatin, irinotecan) and achieved complete response. She was then noted to have slowly rising Ca19-9 level that did not correlate with her lack of evidence of systemic disease progression. Eventually, she presented with neurologic symptoms and was found on imaging to have isolated LMD. |
| Databáze: | Directory of Open Access Journals |
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