Surreal image of cancer cells invading the brain, with a light beam representing treatment.

Gastric Cancer's Silent Spread: A Story of Survival

Kai Mendoza in Health & Wellness December 2025 • 5 min read.

"Discover how a unique treatment approach offered hope in a rare case of leptomeningeal carcinomatosis, and what it means for future cancer care."

Leptomeningeal carcinomatosis (LMC), a condition where cancer spreads to the membranes surrounding the brain and spinal cord, is a rare and challenging complication, especially when it originates from gastrointestinal cancers like gastric cancer. This article explores LMC, also known as carcinomatous leptomeningitis, focusing on a unique case and the potential treatment strategies that offered a positive outcome.

Traditionally, LMC has a grim prognosis, often leading to palliative care to manage symptoms rather than seeking a cure. Diagnosing LMC can be difficult, and survival rates are generally low, making effective treatments crucial. This article examines a case where a patient with gastric cancer-related LMC experienced an unusual symptom – sudden hearing loss – which led to the diagnosis and subsequent treatment.

The case highlights an integrated treatment approach using intrathecal methotrexate, temozolomide, and simultaneous radiotherapy. This strategy aimed to target the cancer cells in the central nervous system while also addressing the primary gastric cancer. By delving into this specific case, we will explore the potential benefits and implications of such treatments for others facing similar diagnoses.

When Cancer Hijacks the Brain: Recognizing Leptomeningeal Carcinomatosis

Surreal image of cancer cells invading the brain, with a light beam representing treatment.

Leptomeningeal carcinomatosis occurs when cancer cells infiltrate the leptomeninges, the delicate membranes enveloping the brain and spinal cord. While LMC is more commonly associated with cancers like leukemia, breast cancer, and lung cancer, its occurrence with gastric cancer is exceedingly rare.

The diagnosis of LMC is often challenging because its symptoms can be vague and mimic other neurological conditions. Definitive diagnosis relies on identifying malignant cells in the cerebrospinal fluid (CSF), obtained through a lumbar puncture. However, the prognosis for LMC remains poor, with most treatments focusing on palliating symptoms rather than achieving a cure.

Hearing Loss as a Red Flag: In the featured case, a 50-year-old man experienced sudden bilateral sensorineural hearing loss, an uncommon symptom that led doctors to investigate further. This unusual presentation highlighted the involvement of the meninges due to metastatic gastric cancer.
Treatment Strategy: The patient underwent a combination of treatments, including intrathecal methotrexate (delivered directly into the CSF), oral temozolomide (a chemotherapy drug), and simultaneous radiotherapy (to target cancer cells in the brain).
Progress and Outcome: The treatment led to a significant period of progress-free survival, lasting approximately 11 months, showcasing the potential of aggressive, multi-modal therapy.

This case provides insight into how LMC from gastric cancer can be managed effectively, challenging traditional expectations of survival and quality of life. It underscores the importance of remaining vigilant for atypical symptoms and considering aggressive, multi-modal treatment options when appropriate.

Hope for the Future: Lessons Learned and Treatment Strategies

This case study reveals several important insights that could shape future approaches to treating LMC from gastric cancer. Early detection, which in this case was aided by an unusual symptom, is paramount. The integration of intrathecal chemotherapy with systemic agents like temozolomide, alongside radiotherapy, may offer a synergistic effect, improving patient outcomes.

While LMC remains a challenging condition, this successful outcome provides a beacon of hope. It suggests that aggressive and well-coordinated treatment plans can significantly extend survival and improve the quality of life for patients. Further research and clinical trials are needed to validate these findings and optimize treatment protocols.

The patient's journey underscores the importance of personalized medicine and tailored treatment strategies. Each case of LMC is unique, and approaches must be adjusted based on the patient's overall health, cancer stage, and individual response to therapy. By sharing this story, the medical community can learn and adapt, continuously improving care for those facing this rare and devastating condition.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1080/15384047.2017.1373218, Alternate LINK

Title: Leptomeningeal Carcinomatosis From Gastric Cancer Successfully Treated By The Intrathecal Methotrexate Plus Temozolomide And Simultaneous Radiotherapy: Case Report And Literatures Review

Subject: Cancer Research

Journal: Cancer Biology & Therapy

Publisher: Informa UK Limited

Authors: Yangyang Liu

Published: 2017-10-03

Everything You Need To Know

What exactly is leptomeningeal carcinomatosis (LMC), and how does it relate to gastric cancer?

Leptomeningeal carcinomatosis (LMC) occurs when cancer cells spread to the leptomeninges, which are the membranes surrounding the brain and spinal cord. This infiltration can lead to various neurological symptoms. While LMC is more commonly associated with cancers like leukemia, breast cancer, and lung cancer, it's less frequent but still possible in cases of gastric cancer. The symptoms of LMC can be vague, making diagnosis challenging.

What specific treatment approach was used, and how do intrathecal methotrexate, temozolomide, and radiotherapy work together in this context?

The presented treatment strategy involved a combination of intrathecal methotrexate, oral temozolomide, and simultaneous radiotherapy. Intrathecal methotrexate delivers chemotherapy directly into the cerebrospinal fluid (CSF), targeting cancer cells within the central nervous system. Temozolomide is a chemotherapy drug administered orally to systemically combat cancer cells. Radiotherapy is used to target and destroy cancer cells in the brain. The combination of these treatments aims to attack the cancer from multiple angles, improving the chances of success.

How can hearing loss be related to gastric cancer and leptomeningeal carcinomatosis?

Hearing loss is not a typical symptom, but in the described case, a 50-year-old man experienced sudden bilateral sensorineural hearing loss. This unusual symptom raised suspicion of meningeal involvement due to metastatic gastric cancer. The hearing loss served as a 'red flag,' prompting further investigation and ultimately leading to the diagnosis of leptomeningeal carcinomatosis. This highlights the importance of considering atypical symptoms in cancer patients.

What does the term 'progress-free survival' mean in the context of leptomeningeal carcinomatosis treatment, and how long did it last in the case described?

The progress-free survival lasted approximately 11 months. This period indicates the time during which the patient experienced a stable condition without the cancer progressing. While not a cure, 11 months of progress-free survival represents a significant improvement in quality of life and an extension of survival compared to the typically poor prognosis associated with LMC. It underscores the potential benefits of aggressive, multi-modal therapy.

What are the key takeaways from this case study that could influence future treatment strategies for leptomeningeal carcinomatosis arising from gastric cancer?

Early detection, aided by recognizing unusual symptoms like hearing loss, is critical. Additionally, integrating intrathecal chemotherapy (methotrexate) with systemic agents like temozolomide, alongside radiotherapy, may offer a synergistic effect, potentially improving patient outcomes. This case challenges traditional expectations and highlights the importance of considering aggressive, multi-modal treatment options. Further research is needed to validate these findings and optimize treatment protocols for LMC from gastric cancer, but this case suggests a promising direction.