case_images: PMC9066584_01
case_images: Cytopathologic finding of cerebrospinal fluid revealing large malignant cells, some with a signet-ring appearance.
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case_images: Subsequently, a lumbar puncture was performed and CSF analysis was compatible with LMC (Figure 1).
case_images: A, B, C: T1-weighted gadolinium-enhanced MRI scan showing brain meningeal enhancement with involvement of the subarachnoid space; D: T1-weighted gadolinium-enhanced MRI scan showing cerebellar and bulbar meningeal enhancement.
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case_images: Brain magnetic resonance imaging (MRI) was performed, showing leptomeningeal enhancement as well as malignant infiltrates at the entire cerebrum (Figure 2).
case_images: PMC9066584_02
case_images: Brain MRI, axial FLAIR, revealing hypersignal and locoregional thickening of the superior frontal sulcus.
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case_images: Head CT scan revealed a hyperintense right frontoparietal lesion with surrounding oedema, suggestive of malignancy on brain MRI (Figure 3).
case_images: Neoplastic cells in the CSF with pleomorphic nuclei and prominent nucleoli.
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case_images: CSF analysis revealed atypical malignant signet-ring cells and gastric adenocarcinoma LMC was assumed (Figure 4).