{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:36:01Z","timestamp":1793741761224,"version":"4.6.1"},"reference-count":11,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,18]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>We describe a case of a 67-year-old man with known chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertension, osteoarthritis, previous history of excess alcohol intake, and oesophagectomy 3\u2009years earlier for T3N0 adenocarcinoma, referred by his general practitioner with confusion, weight loss and several recent falls. CT of the chest, abdomen and pelvis revealed a right middle-lobe pulmonary embolism, while CT of the head revealed a communicating hydrocephalus. Lumbar puncture was performed, and empirical treatment for tuberculous and fungal meningitis was commenced. Unfortunately, he suffered a rapid neurological deterioration with markedly elevated cerebrospinal fluid (CSF) pressures, leading to an external ventricular drain. Cytological analysis of a CSF sample revealed a cellular infiltrate consistent with leptomeningeal carcinomatosis (adenocarcinoma), with the previous oesophageal malignancy the likely primary. He passed away 17 days after hospital admission. Prolonged culture of CSF later produced evidence of two distinct phaeomycotic moulds (<jats:italic>Cladosporium<\/jats:italic> sp and <jats:italic>Exophiala<\/jats:italic> sp), suggesting that fungal meningitis may also have contributed to the clinical picture.<\/jats:p>","DOI":"10.1136\/bcr-2019-230117","type":"journal-article","created":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T10:06:03Z","timestamp":1572689163000},"page":"e230117","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Isolated leptomeningeal carcinomatosis and possible fungal meningitis as late sequelae of oesophageal adenocarcinoma"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1907-4758","authenticated-orcid":false,"given":"Richard","family":"Dumbill","sequence":"first","affiliation":[{"name":"General Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1696-3229","authenticated-orcid":false,"given":"Sanja","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Clinical Geratology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Peschl","sequence":"additional","affiliation":[{"name":"Cardiothoracic Radiology and Emergency Imaging, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GDH","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Woodrow","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,2]]},"reference":[{"key":"2025082713020007000_12.11.e230117.1","unstructured":"Cancer research UK. oesophageal cancer incidence statistics. Available: https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/oesophageal-cancer#heading-Zero [Accessed 7 Oct 2018]."},{"key":"2025082713020007000_12.11.e230117.2","unstructured":"Cancer research UK. oesophageal cancer mortality statistics. Available: https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/oesophageal-cancer\/survival#ref-0. [Accessed 7 Oct 2018]."},{"key":"2025082713020007000_12.11.e230117.3","unstructured":"Cancer research UK. oesophageal cancer treatment statistics. Available: https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/oesophageal-cancer#heading-Four [Accessed 7 Oct 2018]."},{"key":"2025082713020007000_12.11.e230117.4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2015-210974","article-title":"Leptomeningeal carcinomatosis from oesophageal cancer, presenting as meningitis","volume":"2016","author":"Ahmed","year":"2016","journal-title":"BMJ Case Rep"},{"key":"2025082713020007000_12.11.e230117.5","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1007\/s00405-015-3842-z","article-title":"Malignant meningitis secondary to oesophageal adenocarcinoma presenting with sensorineural hearing loss: a series of three cases and discussion of the literature","volume":"273","author":"Adams","year":"2016","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2025082713020007000_12.11.e230117.6","doi-asserted-by":"crossref","unstructured":"Menezes RB , de Lucena AF , Maia FM , et al . Limbic encephalitis as the presenting symptom of oesophageal adenocarcinoma: another cancer to search? BMJ Case Rep 2013;2013. doi:doi:10.1136\/bcr-2012-008201","DOI":"10.1136\/bcr-2012-008201"},{"key":"2025082713020007000_12.11.e230117.7","doi-asserted-by":"crossref","unstructured":"Lobo R , Pillay I , Kennedy B , et al . Confusion and altered behaviour? cause. BMJ Case Rep 2013.","DOI":"10.1136\/bcr-2012-007960"},{"key":"2025082713020007000_12.11.e230117.8","doi-asserted-by":"crossref","unstructured":"Nwankwo N , Mirrakhimov AE , Wind KP , et al . Brain metastasis from oesophageal adenocarcinoma. 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