Key result
Biweekly cisplatinum and 5-Fluoro-Uracil achieves partial remission of metastatic gastric cancer after two months.
Why the study?
Lymphangitic carcinomatosis as a manifestation of gastric carcinoma is rare and presents with misleading, nonspecific symptoms often causing delayed diagnosis.
Case Report (n=1)
Whole body diffusion-weighted magnetic resonance imaging is a promising tool for diagnosing metastatic gastric cancer presenting atypically as pulmonary lymphangitic carcinomatosis.
May support cisplatin/5-FU response in rare pulmonary lymphangitic gastric metastases; leaves open WB-DWI MRI diagnostic validation.
BACKGROUND: Lymphangitic carcinomatosis as a manifestation of gastric carcinoma is rare. The presenting symptoms are misleading and nonspecific, often resulting in delayed diagnosis. CASE PRESENTATION: We present a case of a 24 year old male with progressive dyspnea. Initial radiologic assessment suggested interstitial lung disease, which was subsequently treated with antibiotics and corticosteroids. However, endoscopy and whole body diffusion-weighted magnetic resonance imaging revealed a metastatic gastric cancer with the presence of lymphangitic carcinomatosis. CONCLUSIONS: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic gastric cancer. Patients present with severe but non-specific respiratory complaints. Definitive diagnosis can be achieved by transbronchial biopsy. Prognosis is poor and optimal treatment is not defined. Whole body diffusion-weighted magnetic resonance imaging is a promising imaging tool for the diagnosis of metastatic gastric cancer.
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Moubax et al. (2012) conducted a case report in Pulmonary lymphangitic carcinomatosis secondary to metastatic gastric cancer (n=1). Cisplatinum plus 5-Fluoro-Uracil was evaluated on Radiologic evaluation and clinical symptoms. Treatment with biweekly cisplatinum and 5-Fluoro-Uracil resulted in partial remission of the primary gastric tumor and metastases, with resolution of clinical symptoms after two months.
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