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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Case characteristics
A 43-year-old woman with gastric adenocarcinoma presented with back pain, right radiating leg pain, left facial palsy, and hearing loss.
Clinical diagnosis
Spinal and brain metastases were suspected.
Differential diagnosis
Spinal bone metastasis, brain parenchymal metastasis or leptomeningeal carcinomatosis.
Laboratory diagnosis
All laboratory tests were within normal limits.
Imaging diagnosis
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.
Pathological diagnosis
The postoperative pathologic findings were poorly cohesive carcinoma and the patient was diagnosed with advanced gastric adenocarcinoma.
Treatment
The patient was treated with palliative local radiotherapy.
Related reports
Dural metastasis from primary gastric adenocarcinoma has been rarely reported, and its prognosis is very poor because it frequently leads to subdural hematoma. The prognosis of subdural hematoma caused by dural metastasis is extremely poor, and in most reported cases, the patients died within a short period of time.
Term explanation
Dural metastasis, also named pachymeningeal metastasis, refers to metastasis to the dura mater within the craniospinal axis.
Experiences and lessons
Although dural metastasis from primary gastric adenocarcinoma has been rarely reported, local radiotherapy may be effective for the relief of neurologic symptoms in cases of dural metastasis of gastric adenocarcinoma with an indolent course and controlled systemic disease.
