Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report

Abstract

BackgroundLeptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of leptomeningeal metastasis from hepatocellular carcinoma.Case presentationWe herein report a case of leptomeningeal metastasis from hepatocellular carcinoma in a 53-year-old woman with concomitant systemic metastases to the lung, bone, brain, kidney, adrenal gland, subcutaneous tissues, and abdominal pelvis. The neurological symptoms of the patient were relieved after treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy.ConclusionTo our knowledge this is the first report of leptomeningeal metastasis from hepatocellular carcinoma confirmed by cytology. Treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy was effective.

Hepatocellular carcinoma metastatic to the pituitary gland without an identifiable primary lesion

“…Literature review reveals a paucity of cases of HCC presenting initially with brain metastases [20] , [21] , [22] , [23] . Of all cases, the most common initial manifestation was intracranial hemorrhage due to intracranial metastasis.…”

Isolated brain metastases prior to locoregional recurrence in hilar cholangiocarcinoma

“…Brain metastases, with an incidence of ~5%, usually occurs in patients with primary carcinoma, including breast cancer, lung cancer, and melanoma (6,7). Regarding the brain metastases from HCCA, only a few cases with brain metastases can be located in the previous literature, which is predominantly associated with intrahepatic cholangiocarcinoma (ICC) rather than HCCA (6,8,9).…”

Leptomeningeal metastasis from early glottic laryngeal cancer: A case report

“…LM-directed treatment is currently palliative and its goal is to improve or stabilize the patient's neurological status, improve their quality of life and prolonging their survival time (4). Systemic and intra-CSF chemotherapy and involved-field radiotherapy are common and effective treatments for this disease, and methotrexate is the most commonly utilized intra-CSF chemotherapy drug in the treatment of LM from solid tumors (4,14). In a previous report of a case in which the LM arose from a laryngeal SCC, the patient was treated with intra-CSF methotrexate chemotherapy and palliative radiotherapy.…”