Rare case of pancreatic cancer with leptomeningeal carcinomatosis

World J Gastroenterol. 2015 Jan 21;21(3):1020-3. doi: 10.3748/wjg.v21.i3.1020.


Leptomeningeal carcinomatosis occurs very rarely in patients with pancreatic cancer. Leptomeningeal carcinomatosis is characterized by multifocal seeding of the leptomeninges by malignant cells that originate from a solid tumor. To the best of our knowledge, brain metastasis from pancreatic cancer is extremely rare. Leptomeningeal carcinomatosis is estimated to occur in 3% to 8% of cases of solid tumors. The clinical manifestation usually involves neurological symptoms, including dizziness, headache, vomiting, nausea, and hemiparesis, symptoms similar to those of meningitis or brain tumors. Diagnostic methods for leptomeningeal carcinomatosis include brain magnetic resonance imaging and cerebrospinal fluid examination. Here, we describe a case of leptomeningeal carcinomatosis in which the primary tumor was later determined to be pancreatic cancer. Brain magnetic resonance imaging findings showed mild enhancement of the leptomeninges, and cerebrospinal fluid cytology was negative at first. However, after repeated spinal taps, atypical cells were observed on cerebrospinal fluid analysis and levels of tumor markers such as carbohydrate antigen 19-9 in cerebrospinal fluid were elevated. Abdominal computed tomography, performed to determine the presence of extracerebral tumors, revealed pancreatic cancer. Pancreatic cancer was confirmed histopathologically on examination of an endoscopic ultrasound-guided fine needle aspiration specimen.

Keywords: Leptomeningeal carcinomatosis; Pancreatic cancer; Prognosis; Radiation therapy; Tumor marker.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / cerebrospinal fluid
  • Adenocarcinoma / complications
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / secondary*
  • Aged, 80 and over
  • CA-19-9 Antigen / cerebrospinal fluid
  • Cranial Irradiation
  • Headache / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Carcinomatosis / cerebrospinal fluid
  • Meningeal Carcinomatosis / complications
  • Meningeal Carcinomatosis / radiotherapy
  • Meningeal Carcinomatosis / secondary*
  • Palliative Care
  • Pancreatic Neoplasms / pathology*
  • Predictive Value of Tests
  • Seizures / etiology
  • Tomography, X-Ray Computed


  • CA-19-9 Antigen