|
|
-Case Report-
Leptomeningeal Metastasis from Colorectal Cancer Treated with Folinic Acid, Fluorouracil, and Oxaliplatin Chemotherapy Plus Bevacizumab: A Case Report
1Department of Surgery, Hasuda Hospital, Saitama, Japan
2Department of Surgery, Kamisu Saiseikai Hospital, Ibaraki, Japan
3Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
4Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
5Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
Leptomeningeal metastasis (LM) from colorectal cancer is rare. LM is characterized by rapid progression, making diagnosis and treatment challenging, and are associated with a poor prognosis. A 63-year-old man undergoing chemotherapy with bevacizumab for colorectal cancer was admitted to our hospital with loss of appetite. On admission, he experienced frequent episodes of loss of consciousness. Imaging to identify the underlying cause revealed no abnormalities. Cytological examination of cerebrospinal fluid confirmed LM. Because of worsening symptoms, the patient had difficulty communicating, thus preventing continuation of chemotherapy. He died at 3 weeks post-admission. In patients with cancer who exhibit central nervous system symptoms without abnormal imaging findings, LM should be considered even if the primary tumor is in the transverse colon. In such cases, cytological examination of cerebrospinal fluid and imaging studies should be conducted. This rare case of LM from colorectal cancer after resection and chemotherapy with molecularly targeted agents yielded insights that might guide future treatment strategies.
J Nippon Med Sch 2026; 93: 402-407
Keywords
leptomeningeal metastasis, colorectal cancer, chemotherapy, molecularly targeted agent
Correspondence to
Tomohiro Hayakawa
s00-066@nms.ac.jp
Received, December 5, 2024
Accepted, March 26, 2025
PDF (897K)