Signet-ring Cell Carcinoma of the Colon Causing Meningeal Carcinomatosis—A Case Report—

Abstract

Meningeal carcinomatosis is a disease in which cancer cells diffusely spread to the leptomeninges. It is also called meningitis carcinomatosa. Only few cases of meningeal carcinomatosis arising from colorectal cancer have been reported so far. The case involved a 38-year-old man who was diagnosed with signet-ring cell carcinoma of the transverse colon following close exploration of intestinal obstruction and was operated on. The patient also had peritoneal dissemination and then adjuvant chemotherapy was performed. About eight months later, however, he developed severe headache and was diagnosed as having meningeal carcinomatosis by cytodiagnosis of cerebrospinal fluid. Since his general condition had been unstable, we could not give anticancer therapy. Creation of medullary-peritoneal shunt could provide an about one-week home care period, but he died about one month after the onset of headache.
Once meningeal carcinomatosis occurs, it can often be intractable and carries poor prognosis. Although meningeal carcinomatosis rarely arises from colorectal cancer, the frequency has been reported to be relatively high if the pathological type is poorly differentiated cancer or signet-ring cell carcinoma. In treating signet-ring cell carcinoma of the large intestine, we should keep a possibility of the disease in mind and early diagnosis and treatment are critical if the patient presents with neurological symptoms.