Leptomeningealna karcinomatoza kao manifestacija karcinoma dojke

  • Gorana Mandic Stojmenović Neurology Clinic, Faculty of Medicine, University of Belgrade
  • Aleksandra M Pavlović Neurology Clinic, Faculty of Medicine, University of Belgrade
  • Miilica Skender Gazibara Institute of Pathology, Faculty of Medicine, University of Belgrade
  • Danica Grujičić Neurosurgery Clinic, Faculty of Medicine, University of Belgrade
  • Aleksandra Radojičić Neurology Clinic, Faculty of Medicine, University of Belgrade
  • Nadežda Čovičković Šternić Neurology Clinic, Faculty of Medicine, University of Belgrade
DOI: https://doi.org/10.2298/2395
Ključne reči: breast neoplasms||, ||dojka, neoplazme, neoplasm metastasis||, ||neoplazme, metastaze, meningeal neoplasms||, ||meninge, diagnosis, differential||, ||dijagnoza, diferencijalna,

Sažetak


Uvod. Leptomeningealna karcinomatoza (LK) je ozbiljna komplikacija koja se javlja kod bolesnika sa karcinomima i ima lošu prognozu. Prikaz bolesnika. Prikazali smo 47-godišnju ženu sa 6-mesečnom anamnezom difuzne glavobolje, mučnine i zamagljenja vida. Na početku, klinički status i magnetna rezonanca mozga ukazali su na sindrom idiopatske intrakranijalne hipertenzije. Usled kliničkog pogoršanja i visoke staze papile, pregled cerebrospinalne tečnosti (CST) mogao je biti obavljen tek posle plasiranja ventrikuloperitonealnog šanta. Ovo je dovelo do značajnog, mada prolaznog, kliničkog poboljšanja. Dalje ispitivanje ukazalo je na postojanje invazivnog lobularnog karcinoma dojke, a ponavljanje analize CST otkrile su postojanje malignih ćelija karcinoma dojke. U ovom slučaju LK je bila početna prezentacija maligne bolesti. Zaključak. Ukoliko, uprkos početnim negativnim nalazima, postoji visoka klinička sumnja na LK, kliničar bi trebalo da ponavlja relevantne analize, kao što su magnetna rezonanca sa većom količinom gadolinijuma i analize većeg volumena CST, da bi se postavila dijagnoza.

 

 

Biografije autora

Gorana Mandic Stojmenović, Neurology Clinic, Faculty of Medicine, University of Belgrade
none
Aleksandra M Pavlović, Neurology Clinic, Faculty of Medicine, University of Belgrade
none
Miilica Skender Gazibara, Institute of Pathology, Faculty of Medicine, University of Belgrade
none
Danica Grujičić, Neurosurgery Clinic, Faculty of Medicine, University of Belgrade
none
Aleksandra Radojičić, Neurology Clinic, Faculty of Medicine, University of Belgrade
none
Nadežda Čovičković Šternić, Neurology Clinic, Faculty of Medicine, University of Belgrade
none

Reference

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Waki F, Ando M, Takashima A, Yonemori K, Nokihara H, Miyake M, et al. Prognostic factors and clinical outcomes in patients with leptomeningeal metastasis from solid tumors. J Neurooncol 2009; 93(2): 205−12.

Gauthier H, Guilhaume MN, Bidard FC, Pierga JY, Girre V, Cottu PH, et al. Survival of breast cancer patients with meningeal carcinomatosis. Ann Oncol 2010; 21(11): 2183−7.

Omuro AM, Lallana EC, Bilsky MH, DeAngelis LM. Ventriculoperitoneal shunt in patients with leptomeningeal metastasis. Neurology 2005; 64(9): 1625−7.

Chamberlain M. Leptomeningeal metastasis. Semin Neurol 2010; 30(3): 236−44.

Objavljeno
2017/01/24
Broj časopisa
Vol. 73 Br. 3 (2016)
Rubrika
Prikaz bolesnika