Leptomeningeal Carcinomatosis Presenting Early in Non-Small Cell Lung Cancer

Purpose: we present the case of a patient presenting with altered mental status on post-operative day seven after a diagnostic lung biopsy. The diagnosis of carcinomatous letomeningeal metastasis was confirmed. Methods: we discuss meningeal carcinomatosis in lung cancer, and describe challenges to diagnosis, therapy, and prognosis. Results: a review of the literature describing the clinical and oncologic principles of letomeningeal carcinomatosis in lung cancer is performed. Discussion: leptomeningeal carcinomatosis (LC) occurs in approximately 5% of patients with non-small cell lung cancer and incurs a bleak prognosis. Presenting neurologic symptoms can be varied and diagnosis is confirmed via lumbar puncture and cerebrospinal fluid cytology. Few data exist regarding optimal treatment, although intrathecal chemotherapy has been shown to provide a modest improvement in median survival.