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Neurogenic pulmonary oedema in a patient with leptomeningeal carcinomatosis
  1. R Dammers1,2,
  2. M J van den Bent1
  1. 1Department of Neuro-Oncology, Dr Daniël den Hoed Cancer Clinic, Rotterdam, The Netherlands
  2. 2Department of Neurosurgery, Erasmus Medical Centre, Rotterdam
  1. Correspondence to:
 Dr Martin J van den Bent
 Department of Neuro-Oncology, Dr Daniël den Hoed Cancer Clinic, PO Box 5201, 3008 AE Rotterdam, The Netherlands; m.vandenbent{at}erasmusmc.nl

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We present the case of a patient with leptomeningeal carcinomatosis from a primary breast adenocarcinoma. On admission to hospital, she developed neurogenic pulmonary oedema due to increased intracranial pressure (ICP), as confirmed by lumbar puncture. Tapping of the CSF resulted in abrupt relief of the clinical sequelae.

A woman in her late 40s, with a medical history of breast adenocarcinoma, for which she underwent a modified radical mastectomy with axillar lymph node resection, was admitted to our hospital for intrathecal chemotherapy. Just 1 month earlier, she underwent craniotomy for a solitary metastatic intracerebral lesion in the left frontal lobe. After this uneventful procedure, she continuously complained of drowsiness, nausea and vomiting. A CT scan showed enhancement of cerebral and cerebellar sulci, typical of leptomeningeal metastasis.

This diagnosis prompted admittance to our …

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