Abstract

Dr. Mukesh Bang* and Ramanan S. G.

ABSTRACT

Leptomeningeal carcinomatosis (LC) is a rare complication of cancer in which the disease spreads to the membranes (meninges) surrounding the brain and spinal cord. LC occurs in approximately 5% of people with cancer and is usually terminal. If left untreated, median survival is 4-6 weeks; if treated, median survival is 2-3 months.[1] The most common malignancies associated with LC are lung and breast cancers, melanoma, and hematologic malignancies.[2] LC from gastrointestinal cancers is generally rare. Primary carcinoma of the appendix is very rare, and its incidence has been estimated to be around 0.12 cases per million annually, and invasive adenocarcinomas account for 4–6% of all appendiceal neoplasms.[3] The most reported locations for metastasis in appendiceal adenocarcinoma are regional lymph nodes, peritoneum, ovary, colon, and liver.[4] To the best of our knowledge, there has been one report of leptomeningeal metastasis due to appendiceal adenocarcinoma in the literature thus far. The present case report describes a 61-year-old female patient with diagnosis of high grade mucinous adenocarcinoma of the appendix stage T4, N1, M1 with mucinous ascites S/P cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) who later developed leptomeningeal carcinomatosis diagnosed by CSF analysis.