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Year : 2018  |  Volume : 15  |  Issue : 4  |  Page : 223-225

A rare case of carcinoma pancreas with meningeal metastasis

Department of Surgical Gastroenterology, Indraprastha Apollo Hospital, New Delhi, India

Correspondence Address:
G K Adithya
Department of Surgical Gastroenterology, Indraprastha Apollo Hospital, New Delhi - 110 076
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_34_18

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Carcinoma pancreas is a common malignant disorder of the digestive system. Unfortunately, most cases of pancreatic cancer often present late and are not amenable to surgical cure. Approximately 40% of patients have metastatic disease at the time of presentation. Common metastatic sites include liver, peritoneum, and lung. However, central nervous system metastases are rarely seen in carcinoma pancreas, and most reported cases show lesions in the brain parenchyma. Carcinoma pancreas with meningeal metastasis is an extremely rare presentation, and fewer than 10 cases have been reported in literature. Meningeal infiltration by solid tumors has been reported in 3%–8% of cases. Clinical presentation is similar to meningitis or brain tumors and includes dizziness, nausea, vomiting, neck rigidity, and sensory and motor deficits. Treatment of meningeal metastasis consists of palliative chemotherapy and radiation. The meningeal carcinomatosis has a poor prognosis with median survival of 8–10 weeks. Here, we present a case of carcinoma pancreas with meningeal metastasis, presenting as meningitis. In view of poor general condition of the patient, the Eastern Cooperative Oncology Group score of 4, and after multidisciplinary discussion, only palliative treatment was given. She rapidly deteriorated and succumbed to her illness, 5 days after admission to our hospital.

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