Carcinomatosis menígea: forma inusual de presentación del adenocarcinoma de pulmón

espanolSe presenta el caso de una paciente con antecedentes de ser fumadora de baja intensidad, con indice acumulado de tabaco menor de 5 paquetes/ano y sin otros antecedentes personales de interes. Acudio en diversas ocasiones durante 2 meses a urgencias, refiriendo cefalea difusa, opresiva e intermitente y diplopia acompanada de vision borrosa ocasional, siendo diagnosticada de paralisis isquemica del IV par craneal del ojo izquierdo e iniciando tratamiento con antiagregante. A pesar del tratamiento, a la semana acudio de nuevo a urgencias, ya que progresivamente habia ido presentado mareos, inestabilidad en la marcha, perdida de vision con predominio en ojo izquierdo y mayor sensacion de debilidad en miembros superiores, Finalmente, se decidio ingreso en Neurologia ante la sospecha de meningoencefalitis subaguda tuberculosa, pero tras diversas pruebas diagnosticas se llego a la conclusion de que se trataba de un adenocarcinoma pulmonar, que debuto en forma de carcinomatosis meningea sin haber presentado sintomatologia respiratoria asociada. EnglishA case is presented of a patient with a history of low-intensity smoking, with an accumulated tobacco index of less than 5 packs-year and without other personal history of interest. She went to the emergency room several times over 2 months, complaining of a diffuse, oppressive and intermittent headache and diplopia accompanied by occasional blurred vision, being diagnosed with ischemic paralysis of the fourth cranial nerve of the left eye and initiating treatment with antiplatelets. Despite treatment, she returned to the emergency room within a week, as she had been suffering from progressive dizziness, instability when walking, loss of vision mainly in the left eye and a greater feeling of weakness in the upper limbs. Finally, admission to Neurology was decided upon with the suspicion of subacute tuberculous meningoencephalitis. However, after various diagnostic tests, it was concluded that it was a pulmonary adenocarcinoma, which began as meningeal carcinomatosis without presenting associated respiratory symptoms.