2016 Volume 56 Issue 5 Pages 361-367
Background. The prognosis of carcinomatous meningitis associated with lung cancer is very poor. There are few reports of hydrocephalus secondary to carcinomatous meningitis, and no standard therapy has been established. Case. A 35-year-old woman who had received medical therapy for miliary tuberculosis five years previously presented to us with multiple nodular lesions in the lungs and brain. She was diagnosed with lung adenocarcinoma, cT4N2M1b, stage IV, with carcinomatous meningitis, and was started on treatment with whole-brain irradiation and oral gefitinib. Six weeks later, as the carcinomatous meningitis had worsened, the medication was changed to erlotinib. One year later, the pulmonary tumors had also worsened, and the patient was started on systemic chemotherapy with carboplatin, pemetrexed, and bevacizumab. She developed hydrocephalus, so erlotinib treatment was resumed, and a ventriculo-peritoneal shunt was placed. These treatments resulted in a marked improvement in her performance status, and the patient survived for two years and six months after the diagnosis. Conclusion. We encountered a patient with lung adenocarcinoma and carcinomatous meningitis in whom EGFR-TKI therapy and ventriculo-peritoneal shunt placement proved effective.