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Abstract

RÉSUMÉ
La méningite carcinomateuse ou carcinomatose letpto-méningée est l’envahissement des espaces lepto-méningés par des cellules tumorales (primitives ou secondaires) avec possibilité de passage dans le LCR. Elle correspond à une évolution tardive et grave qui apparait chez 5 à 10% des patients atteints de cancers. La présentation clinique de la méningite carcinomateuse est très polymorphe associant des signes neurologiques relevant de différentes aires du système nerveux (céphalées, atteinte de nerfs crâniens, troubles des fonctions supérieures, raideur cervicale, troubles de la marche, nausées et ou vomissements …). Le diagnostic de certitude repose essentiellement sur l’examen cytologique du LCR qui met évidence la présence de cellules avec anaplasie nucléaire confirmant le caractère malin de la méningite. Les nouvelles techniques d’imageries cérébrales de plus en plus performantes (IRM, TDM) peuvent objectiver des signes contributifs, mais elles peuvent être prises à défaut dans d’authentiques méningites carcinomateuses (faux négatifs). La prise en charge est fonction du type de tumeurs et de la sévérité de la maladie. Le schéma thérapeutique associe une radiothérapie et une chimiothérapie intra-thécale. Nous rapportons une observation de méningite carcinomateuse chez un patient ayant fait un bref passage en neurologie du CHU du Point G avec une revue de la littérature pour attirer l’attention des praticiens sur cette forme clinique particulière de méningite très souvent sous diagnostiquée.

ABSTRACT
Carcinomatous meningitis or carcinomatosis letptomeningeal is the invasion of lepto-meningeal spaces by tumor cells (primitive or secondary) with possibility of passage in the CSF. It corresponds to a late and serious development that occurs in 5 to 10% of cancer patients. The clinical presentation of carcinomatous meningitis is highly polymorphic, associating neurological signs from different areas of the nervous system (headaches, cranial nerve involvement, disorders of superior functions, cervical stiffness, gait disturbances, nausea and / or vomiting ...). The certainty diagnosis is essentially based on the cytological examination of the CSF which shows the presence of cells with nuclear anaplasia confirming the malignant nature of meningitis. The new techniques of increasingly efficient brain imaging (MRI, CT) can objectify contributing signs, but they can be taken failing in authentic carcinomatous meningitis (false negatives). The management depends on the type of tumors and the severity of the disease. The treatment regimen consists of radiotherapy and intra-thecal chemotherapy. We report a case of carcinomatous meningitis in a patient who had a brief neurology in the Point G UHC with a review of the literature to draw the attention of practitioners to this particular clinical form of meningitis very often under diagnosed.

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Sissoko, A. S., Konaté, I., Sissoko, T., Coulibaly, T., Diallo, S., Ziguimé, M., Sacko, M., Keïta, Y., Maïga, Y., & Guinto, C. (2020). Méningite Carcinomateuse Révélant des Métastases d’une Tumeur de Vessie. HEALTH SCIENCES AND DISEASE, 21(11). https://doi.org/10.5281/hsd.v21i11.2169
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