A Case of Meningeal Carcinomatosis from Prostate Cancer

전립선암에서 발생한 수막암종증 1예

  • Seo, Hyun-Woong (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • You, Seung-Hoon (Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jang, Kyeong-Hee (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lee, Joung-Hwa (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Choi, Jong-Soo (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kang, Gil-Hyun (Department of Pathology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Oh, Ho-Suk (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • 서현웅 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 유승훈 (울산대학교 의과대학 강릉아산병원 신경외과학교실) ;
  • 장경희 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 이정화 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 최종수 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 강길현 (울산대학교 의과대학 강릉아산병원 병리학교실) ;
  • 오호석 (울산대학교 의과대학 강릉아산병원 내과학교실)
  • Published : 2011.08.01

Abstract

Meningeal carcinomatosis in patients with prostate cancer is very rare. Recently, we experienced a case of meningeal carcinomatosis in a patient with prostate cancer. He had undergone a radical prostatectomy 11 years before presentation and had undergone chemotherapy 4 years before presentation due to bone metastases. This time, he visited the emergency department because of a seizure. Although cerebrospinal fluid (CSF) examinations did not reveal malignant cells, we diagnosed meningeal carcinomatosis based on positive CSF prostate-specific antigen and magnetic resonance imaging (MRI) findings. The diagnosis was confirmed pathologically. We treated the patient with whole brain radiotherapy and intrathecal chemotherapy. We report a case of prostate cancer with meningeal carcinomatosis with a literature review.

수막암종증은 암세포가 뇌수막에 침윤한 상태로 정의하는데 자기공명영상이 진단방법으로 쓰이기 전까지 진단이 용이하지 않았다. 또한 전립선암 환자에서 수막암종증이 생긴 경우는 매우 희귀하여 증례보고 형식으로 소수에서 보고되고 있는 실정이다. 내원 11년 전 전립선암으로 근치적 전립선 절제술을 받고 내원 4년 전 골전이로 항암치료를 받은 병력이 있는 환자로 경련을 주소로 내원하여 시행한 반복적인 뇌척수액 검사에서 세포진을 발견하지 못했지만 뇌척수액 전립선 특이항원 양성소견과 뇌 자기공명영상 소견으로 수막암종증을 진단하고 조직검사를 통해 확진하여 적극적인 치료로 생명연장을 할 수 있었던 사례를 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

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