Open Access Case report

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

Zhenyu Pan1, Guozi Yang1, Tingting Yuan2, Xiaochuan Pang3, Yongxiang Wang3, Limei Qu4 and Lihua Dong1*

Author Affiliations

1 Department of Radiotherapy, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China

2 Department of Radiology, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China

3 Department of Clinical Laboratory, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China

4 Department of Pathology, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China

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BMC Cancer 2014, 14:399  doi:10.1186/1471-2407-14-399

Published: 3 June 2014

Abstract

Background

Leptomeningeal 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 presentation

We 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.

Conclusion

To 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.

Keywords:
Hepatocellular carcinoma; Metastasis; Leptomeningeal metastasis