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Japanese

A Diffuse Metastatic Leptomeningeal Carcinomatosis from Gallbladder Cancer; Case report Totaro TAKEUCHI 1 , Haruhiko OGAWA 1 , Eishi KASAHARA 1 , Masahito SAKURADA 2 , Suetaka SATOH 3 1Departments of Neurosurgery, Higashimatsuyama Municipal Hospital 2Departments of Internal Medicine, Higashimatsuyama Municipal Hospital 3Departments of Pathology, Higashimatsuyama Municipal Hospital Keyword: Metastatic lepotmeningeal carcinomatosis , Gallbladder cancer , Carcinoembryonic antigen(CEA) pp.1091-1095
Published Date 1991/11/10
DOI https://doi.org/10.11477/mf.1436900358
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Abstract

 We encountered a 72-year-old woman with diffuse metastatic leptomeningeal carcinomatosis, who first suffered from occipital pain and died about a month after onset. On postmortem examination, gallbladder cancer (adenocarcinoma) was found to be the primary disease. We focused on its frequency and the metastatic route. On the metastatic route, we obtained the following results : tumor cells infiltrated only the cerebrospinal fluid, but not the areas surrounding the gallbladder cancer (spine or spinal cord) or into the brain parenchyma. A comparative study of the state of cerebrospinal fluid between the ventricle and the subarachnoid space disclosed that the cerebrospinal fluid pressure, cell count, and CEA and CA 19-9 levels increased more in the intraventricular cerebrospinal fluid, especially when the CEA level was higher than that in the serum. On histopathological examination, tumor emboli were seen in choroidal vessels in the ventricular wall, and tumor cells existed sparsely around choroidal secretory vessels. These results were thought to support the theory of hematogenous metastasis as Little et al proposed.


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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