[A case of advanced gastric cancer patient who died from meningitis carcinomatosa after S-1 + CDDP therapy with good response].

A 68-year-old male who had undergone a distal gastrectomy for gastric cancer in 1996 visited our hospital. Gastroscopy revealed a type 2 tumor at upper corpus, and its biopsy showed poorly differentiated adenocarcinoma. Because enhanced CT showed lymph node swelling at para aorta, S-1 (100 mg/day) was administered for 14 days and CDDP (20 mg/day) was administered for 4 days as 1 course. After 2 courses, the main tumor and lymph node swelling reduced evidently. A total gastrectomy was performed and the pathology revealed no cancer cells in the stomach and dissected lymph nodes. Two months after the operation, speech disturbance and numbness of the left hand appeared. CT showed 3 metastatic brain tumors, and radiation therapy was administered. Four months after the operation, headache appeared and cerebrospinal fluid examination showed adenocarcinoma cells. Although MTX (10 mg) was administered intrathecally, he was died 5 months after the operation.