A slowly progressed case of brain metastasis and meningeal carcinomatosis from lung cancer]

We reported a case of long survival brain metastasis and meningeal carcinomatosis from lung cancer without radiochemotherapy. A 59-year-old female admitted to our hospital suffered from headache, anorexia and nausea. Papilledema was noticed, and examinations showed a brain tumor in the left parietal lobe and cancer cells in cerebrospinal fluid. Removal of the tumor and ventriculoperitoneal shunt were performed. Pathology showed adenocarcinoma. No neurological deficit was found during the postoperative course and the patient asked for home treatment. She survived for 25 months and spent a useful life in the 15 months after the onset in spite of no radiochemotherapy for meningeal carcinomatosis. In this case, because of the slow progression of the clinical symptoms, it is considered that cancer cells in the cerebrospinal fluid space grow slowly. The first CT and MRI findings of metastatic tumor of this case showed atypical for brain metastasis. Calcifications were found in plain CT and a high intensive tumor in both T1 and T2 weighted images of MRI. Enhancement due to contrast media was very slight in both CT and MRI. We considered that these findings were related to the slow growing of cancer cells.