Rare Presentation of Gastric Cancer as Leptomeningeal Carcinomatosis and Inappropriate Antidiuretic Hormone Secretion Syndrome: Case Report
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https://doi.org/10.60591/crspmi.188Keywords:
Inappropriate ADH Syndrome, Meningeal Carcinomatosis, Stomach NeoplasmsAbstract
Leptomeningeal carcinomatosis (LC) and paraneoplastic
syndrome of inappropriate antidiuretic hormone secretion (SIADH) are rarely associated with gastric cancer, especially as presenting forms of asymptomatic gastric cancer.
An 87-year-old woman was admitted because of lethargy,
mnesic deficit, disorientation and gait instability affecting
her autonomy for 20 days. Laboratory tests were suggestive
of SIADH, body computed tomography (CT) scan showed
lymph nodes near the lesser omentum and cerebrospinal fluid showed elevated protein and low glucose. Gastroscopy revealed an ulcerated lesion at the incisura angularis. She had a rapid unfavourable outcome with hydrocephalus and recurrent seizures. Head magnetic resonance imaging scan was suggestive of LC and gastric biopsy showed poorly cohesive carcinoma with some signet ring cells. Neoplastic cells in cerebrospinal fluid were positive and compatible with carcinoma. The patient died without any possibility of treatment.
The authors want to emphasize the possibility of LC and
SIADH as rare presenting forms of gastric cancer.
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Copyright (c) 2024 Inês Silva, Ryan Costa Silva, Mariana Cerejo Silva, Sofia Reimão, Lígia Peixoto
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