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Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?

Complication of leptomeningeal carcinomatosis (LMC) is critical. It causes rapid neurological deterioration, and subsequently, discontinuation of the ineffective treatment even in body tumor dormancy. Large molecular chemotherapeutic agents that are unlikely to penetrate the CSF space, are more like...

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Autores principales: Sayanagi, Taichi, Ohishi, Yumiko, Katayama, Makoto, Tamura, Ryota
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317958/
https://www.ncbi.nlm.nih.gov/pubmed/35877817
http://dx.doi.org/10.3390/medicines9070039
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author Sayanagi, Taichi
Ohishi, Yumiko
Katayama, Makoto
Tamura, Ryota
author_facet Sayanagi, Taichi
Ohishi, Yumiko
Katayama, Makoto
Tamura, Ryota
author_sort Sayanagi, Taichi
collection PubMed
description Complication of leptomeningeal carcinomatosis (LMC) is critical. It causes rapid neurological deterioration, and subsequently, discontinuation of the ineffective treatment even in body tumor dormancy. Large molecular chemotherapeutic agents that are unlikely to penetrate the CSF space, are more likely to not treat LMC, typically in chemo-sensitive tumors. With the introduction of novel regimens, significant advances in overall survival have been observed even in formerly chemo-resistant tumors, such as pancreatic cancer. Although such cases are still rare, the number of pancreatic cancer patients complicated with LMC are increasing, and this therefore needs more recognition. A 49-year-old woman was diagnosed with stage IVa pancreatic cancer. She underwent surgery, and subsequent adjuvant chemotherapy. After three lines of chemotherapy over a 3-year period, where the body disease remained dormant, the patient was complicated by LMC. The diagnosis was made 4 months after the onset of headache. The patient received intrathecal methotrexate treatment but succumbed shortly after treatment induction. Pancreatic cancer is still relatively chemo-resistant and is one of the least likely types of tumor to be complicated by LMC due to patients dying of the primary tumor. Advancements in treatments have led to a prolonged period of primary tumor control, but not in the CNS due to the poor penetration of chemo-agents to this site. The present case seems to be a typical result of modern era anti-cancer therapy. Therefore, we emphasize the necessity of earlier recognition of this complication so that we can initiate specific treatment targeting the CSF space, especially in this formerly chemo-resistant tumor in order to improve its prognosis.
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spelling pubmed-93179582022-07-27 Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon? Sayanagi, Taichi Ohishi, Yumiko Katayama, Makoto Tamura, Ryota Medicines (Basel) Communication Complication of leptomeningeal carcinomatosis (LMC) is critical. It causes rapid neurological deterioration, and subsequently, discontinuation of the ineffective treatment even in body tumor dormancy. Large molecular chemotherapeutic agents that are unlikely to penetrate the CSF space, are more likely to not treat LMC, typically in chemo-sensitive tumors. With the introduction of novel regimens, significant advances in overall survival have been observed even in formerly chemo-resistant tumors, such as pancreatic cancer. Although such cases are still rare, the number of pancreatic cancer patients complicated with LMC are increasing, and this therefore needs more recognition. A 49-year-old woman was diagnosed with stage IVa pancreatic cancer. She underwent surgery, and subsequent adjuvant chemotherapy. After three lines of chemotherapy over a 3-year period, where the body disease remained dormant, the patient was complicated by LMC. The diagnosis was made 4 months after the onset of headache. The patient received intrathecal methotrexate treatment but succumbed shortly after treatment induction. Pancreatic cancer is still relatively chemo-resistant and is one of the least likely types of tumor to be complicated by LMC due to patients dying of the primary tumor. Advancements in treatments have led to a prolonged period of primary tumor control, but not in the CNS due to the poor penetration of chemo-agents to this site. The present case seems to be a typical result of modern era anti-cancer therapy. Therefore, we emphasize the necessity of earlier recognition of this complication so that we can initiate specific treatment targeting the CSF space, especially in this formerly chemo-resistant tumor in order to improve its prognosis. MDPI 2022-07-12 /pmc/articles/PMC9317958/ /pubmed/35877817 http://dx.doi.org/10.3390/medicines9070039 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Sayanagi, Taichi
Ohishi, Yumiko
Katayama, Makoto
Tamura, Ryota
Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?
title Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?
title_full Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?
title_fullStr Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?
title_full_unstemmed Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?
title_short Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer: A Rare Phenomenon?
title_sort leptomeningeal carcinomatosis in a patient with pancreatic cancer: a rare phenomenon?
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317958/
https://www.ncbi.nlm.nih.gov/pubmed/35877817
http://dx.doi.org/10.3390/medicines9070039
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