Abstract
A 53-year-old man complaining of dyschezia and diagnosed with rectal cancer with paraaortic lymph node metastasis underwent low anterior resection with D2 lymph node dissection in September 2012. Chemotherapy was applied post-surgery. The paraaortic lymph node metastases had shrunken and a partial response was maintained. The patient presented at our hospital with complaints of dysuria and weakness in the lower extremities. Magnetic resonance imaging (MRI) suggested a metastatic cauda equina tumor. Several days after admission, the patient experienced bilateral sensorineural hearing loss. Gadolinium-enhanced magnetic resonance imaging revealed enhancement of the cauda equina and thoracic spinal cord and diffuse enhancement of the surface of the brain. Furthermore, the bilateral internal auditory canal was enhanced. Therefore, the patient was diagnosed with meningeal carcinomatosis. Whole brain radiotherapy (30 Gy total) was applied. After radiotherapy, combination chemotherapy with folinic acid-fluorouracil-irinotecan and bevacizumab was applied. However, the condition of the patient gradually worsened and he eventually died 9 weeks after onset of the primary symptoms. We hereby report the case together with a short literature review, as meningeal carcinomatosis caused by colorectal carcinoma is rare.
