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Adenocarcinoma of the Lung Complicated with Leptomeningeal Carcinomatosis: Report of Two Cases

肺腺細胞癌合併軟腦膜轉移:兩病例報告

摘要


軟腦膜轉移是肺腺細胞癌的重要併發症,不易正確診斷故臨床少見報告,發生率亦不明。我們在此報告兩病例,臨床皆以頭痛、癲癇發作及頸部僵硬來表現。其中一例因未有癌症病史,而與結核性腦膜炎相混淆。診斷之確立依靠腦脊髓液細胞學生檢及電腦斷層、核磁共振造影。對肺非小細胞癌而言,一旦有軟腦膜轉移,雖經治療,愈後仍不佳。

關鍵字

腺細胞癌 軟腦膜轉移

並列摘要


Leptomeningeal carcinomatosis (LM) is a clinically important complication of adenocarcinoma of the lung. However, because it is difficult to diagnose, LM is rarely reported. We report two cases in which the initial signs and symptoms were headache, seizure attack, and nuchal rigidity. The first case was suspected to be tuberculosis meningitis on the basis of shared symptoms, signs, and laboratory data from cerebrospinal fluid analysis. The diagnoses of both cases were established by cytology of the cerebrospinal fluid and supported by neuroimaging. However, the prognosis for LM is poor despite aggressive present-day treatment.

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