Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2018; 24(5): 651-656
Published online Feb 7, 2018. doi: 10.3748/wjg.v24.i5.651
Sequential spinal and intracranial dural metastases in gastric adenocarcinoma: A case report
Hongsik Kim, Kyung Sik Yi, Won-Dong Kim, Seung-Myoung Son, Yaewon Yang, Jihyun Kwon, Hye Sook Han
Hongsik Kim, Yaewon Yang, Jihyun Kwon, Hye Sook Han, Department of Internal Medicine, Chungbuk National University Hospital, Seowon-gu, Cheongju 28644, South Korea
Kyung Sik Yi, Department of Radiology, Chungbuk National University Hospital, Seowon-gu, Cheongju 28644, South Korea
Won-Dong Kim, Department of Radiation Oncology, College of Medicine, Chungbuk National University, Seowon-gu, Cheongju 28644, South Korea
Won-Dong Kim, Department of Radiation Oncology, Chungbuk National University Hospital, Seowon-gu, Cheongju 28644, South Korea
Seung-Myoung Son, Department of Pathology, Chungbuk National University Hospital, Seowon-gu, Cheongju 28644, South Korea
Hye Sook Han, Department of Internal Medicine, College of Medicine, Chungbuk National University, Seowon-gu, Cheongju 28644, South Korea
Author contributions: Kim H and Han HS designed the report; Kim H, Yi KS, Kim WD, Son SM and Han HS collected the patient’s clinical data; Kim H, Yang Y, Kwon J and Han HS contributed to data interpretation and drafting of the article; all authors read and approved the final version of this manuscript.
Informed consent statement: Written informed consent for publication of this case report and associated images was obtained from the patient.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hye Sook Han, MD, PhD, Associate Professor, Department of Internal Medicine, College of Medicine, Chungbuk National University, Chungdae-ro 1, Seowon-gu, Cheongju, 28644, South Korea. sook3529@hanmail.net
Telephone: +82-43-2696306 Fax: +82-43-273-32
Received: November 13, 2017
Peer-review started: November 14, 2017
First decision: December 6, 2017
Revised: December 10, 2017
Accepted: December 26, 2017
Article in press: December 26, 2017
Published online: February 7, 2018
Processing time: 78 Days and 14.3 Hours
Abstract

Dural metastasis from primary gastric adenocarcinoma has been rarely reported, and its prognosis is very poor because it frequently leads to acute subdural hematoma. Here, we describe a case with sequential spinal and cranial dural metastases from gastric adenocarcinoma without subdural hematoma. A 43-year-old woman with gastric adenocarcinoma and well-controlled peritoneal carcinomatosis presented with back pain, right radiating leg pain, left facial palsy, and hearing loss. Magnetic resonance imaging of the spine and brain revealed dural masses at the lumbosacral junction with invasion to the L5 and S1 nerve roots and at the skull base with invasion to the internal auditory canal. She was treated with local radiotherapy, and her pain and neurologic symptoms improved after palliative radiotherapy. This is the first reported case of dural metastases of gastric adenocarcinoma of the spine and skull base but with a relatively indolent course and without subdural hematoma.

Keywords: Adenocarcinoma; Gastric; Metastasis; Dura; Radiotherapy

Core tip: Although gastric adenocarcinoma can metastasize to almost any organ, metastasis to the dura mater is rarely reported. Here, we report a rare and clinically meaningful case of dural metastases to the spine and skull base from gastric adenocarcinoma that was treated with palliative local radiotherapy. This is the first reported case of dural metastases of gastric adenocarcinoma of the spine and skull base with involvement of the surrounding structures but with a relatively indolent course and without subdural hematoma. Local radiotherapy was effective for the relief of neurologic symptoms.