Leptomeningeal carcinomatosis of the spinal cord originating from nasopharyngeal carcinoma

Abstract

We report on a 44-year-old man with nasopharyngeal carcinoma with intracranial extension and leptomeningeal metastases in the spinal cord. Marked resolution of the nasopharyngeal carcinoma and leptomeningeal metastases was achieved by using cisplatin-based chemotherapy for six cycles. He was then treated by radiotherapy to residual leptomeningeal metastases at a dose of 30 Gy over 10 fractions, followed by high-dose palliative radiotherapy of 60 Gy over 30 fractions to the nasopharynx and regional lymph nodes. Excellent tumour shrinkage with prolonged survival of more than 1 year was achieved. To the authors' knowledge, this is the first published report of nasopharyngeal carcinoma resulting in leptomeningeal disease of the spinal cord. © 2013 Hong Kong College of Radiologists.