{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T16:42:25Z","timestamp":1775925745424,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Meningeal carcinomatosis (MC) is a severe complication of systemic cancers. Although typical presentations involve meningeal irritation or cranial nerve deficits, its manifestation as rapidly progressive dementia (RPD) in the absence of classic signs is exceedingly rare. This complication poses a substantial diagnostic challenge, especially when the primary tumor remains occult.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present the case of a 56-year-old man with a 4-month history of progressive cognitive decline, behavioral changes, and visual hallucinations culminating in stupor. The diagnostic evaluation consisted of a comprehensive neurologic examination, contrast-enhanced brain magnetic resonance imaging, cerebrospinal fluid (CSF) analysis, and whole-body 18F-fludeoxyglucose\u2013positron emission tomography\/computed tomography (FDG\u2013PET\/CT) imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Brain magnetic resonance imaging revealed diffuse leptomeningeal enhancement. FDG\u2013PET\/CT demonstrated abnormal FDG uptake localized to the cerebellar cortex and basal meninges; however, no primary tumor was identified. A CSF analysis showed elevated opening pressure, pleocytosis, and increased protein; cytology confirmed malignant cells. Immunohistochemical profiling (CK7+, TTF1+, MOC31+, Ki-67 40%+, BerEp4+, EMA+) indicated adenocarcinoma of probable pulmonary origin, confirming MC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case underscores that RPD can be a rare but dominant initial feature of MC and highlights the essential role of CSF cytology combined with immunohistochemistry in achieving a definitive diagnosis, especially when neuroimaging is nonspecific and a primary tumor is not detected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/labmed\/lmag008","type":"journal-article","created":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T12:32:58Z","timestamp":1772368378000},"source":"Crossref","is-referenced-by-count":0,"title":["A case report of meningeal carcinomatosis presenting as rapidly progressive dementia: cytological diagnosis with ancillary immunohistochemistry of cerebrobrospinal fluid cells"],"prefix":"10.1093","volume":"57","author":[{"given":"Xiaoxuan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Neurology, Shengjing Hospital of China Medical University , Shenyang,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shengjing Hospital of China Medical University , Shenyang,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0151-0964","authenticated-orcid":false,"given":"Dongming","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shengjing Hospital of China Medical University , Shenyang,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"2026041111434385400_lmag008-B1","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s11060-004-8101-x","article-title":"Leptomeningeal metastases from solid malignancy: a review","volume":"75","author":"Taillibert","year":"2005","journal-title":"J Neurooncol"},{"key":"2026041111434385400_lmag008-B2","doi-asserted-by":"publisher","first-page":"207","DOI":"10.4103\/0976-3147.98253","article-title":"Carcinomatous meningitis: yet another cause for rapidly progressive dementia and triphasic waves in electroencephalograph","volume":"3","author":"Jadav","year":"2012","journal-title":"J Neurosci Rural Pract"},{"key":"2026041111434385400_lmag008-B3","first-page":"383","article-title":"Carcinomatous meningitis mimicking Creutzfeldt-Jakob disease","volume":"52","author":"Vas","year":"2004","journal-title":"Neurol India"},{"key":"2026041111434385400_lmag008-B4","doi-asserted-by":"publisher","first-page":"e22923","DOI":"10.7759\/cureus.22923","article-title":"Neurology case report: rapidly progressive dementia and extrapyramidal symptoms as the first presentation of leptomeningeal carcinomatosis","volume":"14","author":"Alhubayshi","year":"2022","journal-title":"Cureus"},{"key":"2026041111434385400_lmag008-B5","doi-asserted-by":"publisher","first-page":"e137","DOI":"10.1002\/pcn5.137","article-title":"Crucial differential diagnosis of rapidly progressive dementia: a case of leptomeningeal metastasis","volume":"2","author":"Mimura","year":"2023","journal-title":"PCN Rep"},{"key":"2026041111434385400_lmag008-B6","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1002\/1097-0142(19820215)49","article-title":"Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients","volume":"49","author":"Wasserstrom","year":"1982","journal-title":"Cancer"},{"key":"2026041111434385400_lmag008-B7","doi-asserted-by":"publisher","first-page":"73312","DOI":"10.18632\/oncotarget.20272","article-title":"Leptomeningeal disease: current diagnostic and therapeutic strategies","volume":"8","author":"Nayar","year":"2017","journal-title":"Oncotarget"},{"key":"2026041111434385400_lmag008-B8","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1038\/s41571-024-00970-3","article-title":"Leptomeningeal metastatic disease: new frontiers and future directions","volume":"22","author":"Ozair","year":"2025","journal-title":"Nat Rev Clin Oncol"},{"key":"2026041111434385400_lmag008-B9","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1212\/wnl.5.10.706","article-title":"Diffuse leptomeningeal carcinomatosis; clinical and pathologic characteristics","volume":"5","author":"Grain","year":"1955","journal-title":"Neurology"},{"key":"2026041111434385400_lmag008-B10","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1001\/archneur.1996.0055070064013","article-title":"Leptomeningeal carcinomatosis. 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