A case of meningeal carcinomatosis and small cell lung carcinoma effectively treated using a multidisciplinary approach

A 65-year-old man visited our hospital with dyspnea and cough. He was diagnosed with small cell lung carcinoma (cT4N2M1b, Stage IV). The disease partially responded to systemic chemotherapy. However, it was progressive and metastasized to the brain 3 months after 6 courses of chemotherapy. Therefore, whole brain irradiation was performed. Subsequently, weakness of the lower extremities and vesicorectal disturbances appeared. Meningeal carcinomatosis was diagnosed by enhanced magnetic resonance imaging and liquid examination. Methotrexate plus cytarabine plus dexamethasone was injected intrathecally and spinal irradiation was performed. An Ommaya reservoir was placed and intrathecal chemotherapy was continued. Systemic chemotherapy was also administered. Consequently, his symptoms improved and he was successfully discharged. Therefore, a multidisciplinary approach should be considered to improve the symptoms of patients with meningeal carcinomatosis.