[Basal skull metastasis of stomach cancer presenting with Garcin's syndrome--a case report]

Abstract

A case of 57-year-old man with Garcin's syndrome is reported. By means of upper gastrointestinal endoscopy, this patient proved to have a stomach cancer. He noticed left trigeminal neuralgia for the first time in early Jan. 1986, and when he was referred to our department, his symptoms and signs of left cranial nerve palsy (from 5th to 12th, totally 8 nerves) were complete, although other neurological findings such as long tract signs, cerebellar signs, or papilledema were all negative. Although skull X-ray and basal skull tomography revealed neither bony deformity nor destruction, CT scan and angiography showed suspicious appearance of basal skull invasion of a certain mass. CSF examination revealed no malignant cells or abnormal protein, and sugar content. Exploratory craniotomy for tumor biopsy was performed. Histologically, the tumor had characteristics of anaplastic carcinoma. General survey revealed that he had a stomach cancer which was histologically the same as the basal skull tumor. His general condition became so serious that irradiation to the lesion was not indicated Among many papers reported about Garcin's syndrome, those of basal skull metastasis of stomach cancer are extremely rare. The authors discussed the lesion in comparison with meningeal carcinomatosis involving cranial nerves.