A fatal case of meningeal carcinomatosis in a stage IV rectal cancer patient who had long time survival by multi- line chemotherapy

A 65-year-old man was referred with Stage IV rectal cancer with lung and liver metastasis. He had done low anterior resection. One month after operation, he was administered anti-cancer drugs of FOLFOX4 protocol. Six months after operation, partial response was obtained of abdominal CT scan evaluation. Nine months after operation, FOLFOX4 was stopped by peripheral nerve injuries. FOLFIRI protocol started as second-line chemotherapy. Nineteen months after operation, he was diagnosed left hydro-nephrosis by retro peritoneal lymph-node metastasis. He was treated by urethral stenting, and FOLFOX protocol was re-started. Twenty one months after operation, FOLFOX4 was stopped by drug allergy, and changed to FOLFIRI protocol. Twenty five months after operation, He felt difficulty of walking and dizziness. He was diagnosed meningeal carcinomatosis by brain CT scan. He was administered glycerol and steroid. His neurological symptoms was improved. Although he died of disease progression at twenty six months after operation.