Abstract
A case of lepto-meningeal cartinomatosis in a patient undergoing total gastrectomy with excision of the pancreas and spleen for an advanced gastric cancer (Borrmann 3) was experienced. In this case intramedullary administration of anticancer agents was effective.
A 62-year-old man presented severe headache 10 months after operation for a gastric cancer, which was histologically signet ring cartinoma with invasion depth of se, ly3, and v0. Spinal fluid revealed signet ring cartinoma cells. CEA level was normal in serum but high in spinal fluid, which was an avarable information for diagnosis. Intramedullary administration of methotrexate and cytosine arabinoside 15 times remarkably decreased cartinoma cells, normalized CEA level, and could yielded an 8-month disease-free period. In a review of the literature we can see a fact that almost all patients will die within 3 months after the onset of the disease. However, general chemotherapy combined with intramedullary dosing of antineoplasms can offer life-prolomgation effect like this case, and hence the importance of such aggressive regimen would be emphasized.
