Leptomeningeal Carcinomatosis as a Presentation of Relapse in Adenocarcinoma of Colon: A Case Report and Review

The incidence of leptomeningeal carcinomatosis (LC) has been increasing, due to advances in the cancer and the improved overall survival of cancer patients. Breast and lung cancer are the most frequently reported causes of LC among solid tumors. LC occurs very rarely in patients with colon cancer. Leptomeningeal carcinomatosis is characterized by multifocal seeding of the leptomeninges by malignant cells that originate from a solid tumor. The median survival of untreated patients is 4 to 6 weeks. Although the diagnosis may be challenging, an early treatment before the setting of neurological deficits is required in order to improve the clinical outcomes. The treatment requires a multidisciplinary approach by a combination of chemotherapy and targeted therapies administrated systemically or via intra-cerebrospinal fluid route, surgery and radiotherapy. Here, we describe a case of leptomeningeal carcinomatosis in which the primary tumor was colon cancer that has progressed to LC but responded significantly to our treatment strategy. Also, we review the literature on carcinomatosis in solid tumors.