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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.32 no.4 São Paulo Dec. 1974

http://dx.doi.org/10.1590/S0004-282X1974000400004 

Carcinomatose das meninges. Dados clínico-patológicos de 3 casos

 

Carcinomatosis of the meninges: a report of three cases

 

 

Aristides Cheto de QueirozI; Carlos Renato MeloII

IServiço de Anatomia Patológica do Hosp. Prof. Edgard Santos, Salvador BA: Prof. Assistente do Departamento de Patologia Aplicada e Medicina Legal (setor Patologia Aplicada), da Faculdade de Medicina da Universidade da Bahia
IIServiço de Anatomia Patológica do Hosp. Prof. Edgard Santos, Salvador BA: Mestrando em Patologia Humana. Bolsista da CAPES

 

 


RESUMO

Foram estudados 3 casos de carcinomatose das meninges, autopsiados no serviço de Anatomia Patológica do Hospital Prof. Edgard Santos. O quadro neurológico apresentado era proeminente e representado por sinto- matologia decorrente do envolvimento meníngeo e encefálico, razão pela qual foram considerados como portadores de meningite tuberculosa e encefalomielite. O aspecto de maior interesse neste estudo foi a discrepância entre o quadro clínico e os dados anátomo-patológicos do exame do encéfalo. A sintomatologia clínica foi proeminente, enquanto as lesões anatômicas foram apenas discretas ou moderadas e representadas por espessamento e granulosidade das meninges, com infiltração difusa do espaço subaracnoideano pela neoplasia. Nos casos 1 e 3 a neoplasia estava representada por adenocarcinoma, cujos focos primitivos foram localizados no pulmão e vesícula biliar, respectivamente. O caso 2 era um carcinoma indiferenciado do estômago, com envolvimento difuso do espaço subaracnoideano e subdural, havendo neste último extensa hemorragia recente. Os critérios diagnósticos e a maneira de disseminação desta condição são discutidos.


SUMMARY

A diffuse involvement of the meninges by carcinoma is described in three cases characterizing the so called "meningeal carcinomatosis". The neurologic symptoms were those of the chronic meningitis or encephalomyelitis, with changes in the spinal fluid. The morphologic features were identical in the three cases and represented by slight to moderate thickening of the meninges by diffuse infiltration of tumor cells and few foci of inflamatory reaction. The cases 1 and 3 were represented by well differentiated adenocarcinoma with primary site in the lung and gallbladder, respectively. In case 2 the tumor was a poorly differentiated carcinoma of stomach with diffuse involvement of the arachnoid and dura mater associated with recent hemorrhage. An interesting point was the lack of correlation between clinical and pathological findings. The clinical symptoms were very prominent and the gross findings only slight to moderate. The criteria for diagnosis of this entity as well as the mechanism of dissemination of the carcinoma to the meninges are reviewed and discussed.


 

 

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Hospital Prof. Edgar Santos — Faculdade de Medicina, Universidade Federal da Bahia — Serviço de Anatomia Patológica — 40000 Salvador BA — Brasil.

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