Meningeal carcinomatosis as presenting symptom of a gallbladder carcinoma.

Meningeal carcinomatosis as presenting symptom is rare. We report a patient who presented with an isolated abducens nerve palsy and an unsteady gait. At autopsy the primary tumor proved to be a gallbladder carcinoma. Only one similar case has been reported. Several aspects are discussed, including the route by which the tumor cells could have reached the subarachnoid space.