Leptomeningeal carcinomatosis from ethmoid sinus adenocarcinoma

Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Feb;131(1):49-51. doi: 10.1016/j.anorl.2012.07.004. Epub 2012 Dec 27.

Abstract

Introduction: Adenocarcinoma of the ethmoid is an aggressive tumor, with potential extension to surrounding structures. Leptomeningeal extension is a rarely reported entity.

Case report: A carpenter, aged 55, developed multifocal cranial nerve-related symptoms 1 week after resection of adenocarcinoma of the ethmoid, evolving towards deteriorated general health status and death 10 weeks later. Brain MRI showed diffuse contrast enhancement of the cranial nerves, and repeated cerebrospinal fluid (CSF) examination found increased protein concentration associated with decreased glucose concentration, without malignant cells. The diagnosis of carcinomatous meningitis was based on the association of clinical, CSF and brain MRI data.

Discussion/conclusion: Leptomeningeal dissemination of adenocarcinoma of the ethmoid is rare; diagnosis is guided by clinical signs. MRI reveals neurological spread, but the presence of malignant cells in the CSF is sufficient for diagnosis. Due to poor prognosis, the only currently available treatments are palliative.

Keywords: Adenocarcinoma; Ethmoid sinus; Meningeal carcinomatosis; Paranasal sinus neoplasms.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / secondary*
  • Ethmoid Sinus*
  • Humans
  • Male
  • Meningeal Carcinomatosis / diagnosis
  • Meningeal Carcinomatosis / secondary*
  • Middle Aged
  • Paranasal Sinus Neoplasms / pathology*