Administration of gefitinib via nasogastric tube effectively improved the performance status of a patient with lung adenocarcinoma-derived meningeal carcinomatosis

Meningeal carcinomatosis (MC) is a refractory disease with a dismal prognosis, and no therapeutic strategy has been established to date. Herein we report a case of lung adenocarcinoma-derived MC in which the patient’s performance status was dramatically improved by administration of gefitinib suspension via a nasogastric tube. The patient was a 71-year-old woman who was originally admitted to our hospital for a progressive headache and subsequently presented with severe consciousness disturbance. Cerebrospinal fluid examination and systemic imaging studies revealed MC that was derived from lung adenocarcinoma. Moreover, epidermal growth factor receptor (EGFR) mutations were detected in the tumor cells. Since the patient suffered from hydrocephalus, a ventriculoperitoneal shunt was placed. Nevertheless, her consciousness disturbance persisted. Subsequently, gefitinib suspension was prepared and administered via nasogastric tube, which dramatically improved her consciousness level and enabled her to tolerate oral intake. She died 14 months after the disease onset. The observations in this case report suggest that gefitinib might be a therapeutic option for patients with MC derived from cancers harboring EGFR mutations even though the patient exhibited severe consciousness disturbance.