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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Dubrey, Simon Mohan, Poornima Antonelou, Marilina Dadzie, Ophelia |
| Description | Author Affiliation: Mohan P ( Department of Acute Medicine, Hillingdon Hospital, Uxbridge, UK.); Antonelou M ( Department of Medicine, Hillingdon Hospital, Uxbridge, UK.); Dadzie O ( Department of Histopathology, Hillingdon Hospital, Uxbridge, UK.); Dubrey S ( Department of Cardiology, Hillingdon Hospital, Uxbridge, Middlesex, UK.) |
| Abstract | A 37-year-old woman presented with a 2-week history of persistent headache in an occipitotemporal distribution. The patient had experienced prior headaches and migraines, but this presentation was characterised by its intensity and duration. There was associated dizziness and blurring of vision in episodes occurring up to 4-5 times per day. Whole body cross-sectional CT imaging and MRI of neuronal axes were normal. Cerebrospinal fluid cytology demonstrated large abnormal pleomorphic cells expressing the tumour marker CA125. Positron emission tomography-fluorodeoxyglucose revealed bilateral axillary and cervical lymphadenopathy as well as increased uptake in the lateral regions of both breasts. These results correlated with MRI breast and mammography findings. Axillary lymph node biopsy showed poorly differentiated adenocarcinoma making the diagnosis of breast malignancy, the most likely primary site of metastatic leptomeningeal disease. In the 6-week interval between initial presentation and diagnosis, the patient deteriorated significantly with the new onset of facial nerve palsy and partial seizures. The treatment intent was palliative, focusing on symptom control with systemic chemotherapy and whole brain radiotherapy. |
| Volume Number | 2015 |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Adenocarcinoma Diagnosis Secondary Breast Neoplasms Pathology Headache Etiology Meningeal Neoplasms Palliative Care Complications Therapy Adult Antineoplastic Combined Chemotherapy Protocols Therapeutic Use Cranial Irradiation Epilepsies, Partial Facial Paralysis Fatal Outcome Female Humans Magnetic Resonance Imaging Mammography Methods Positron-Emission Tomography Tomography, X-Ray Computed Case Reports Journal Article Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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