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  • Title: Rapidly developing leptomeningeal carcinomatosis following anterior skull base surgery: a case report.
    Author: Vellin JF, Achim V, Sinardet D, Gabrillargues J, Mom T, Gilain L.
    Journal: Auris Nasus Larynx; 2007 Dec; 34(4):565-7. PubMed ID: 17507192.
    Abstract:
    Leptomeningeal carcinomatosis is rare in evolution of head and neck cancers. Prognosis is poor and treatment is through supportive care. We report an atypical rapid post-operative leptomeningeal carcinomatosis after skull base resection for an ethmoidal adenocarcinoma. The anterior skull base resection was near-total and we suspect a seeding of subarachnoid space either before surgery, either during surgical extirpation or from the residual intracranial nodule. It is the first description of rapid LMC after surgery (less than 1 month). Post-operative MRI diagnosed the LMC through the detection of contrast enhancing leptomeningeal nodules at bilateral second and eighth cranial nerves and at bilateral interpedoncular area. A strong index of suspicion along with clinical and radiological correlation is essential to arrive at a correct diagnosis. Otolaryngologists should be aware of the possibility of leptomeningeal carcinomatosis, before or after surgery, in a patient presents with an appropriate constellation of neurologic symptoms and a history of cancer.
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