Colorectal cancer presenting with dysarthria and ataxia: a case of isolated leptomeningeal metastasis.

We report the case of a 72-year-old man who presented with weight loss, anorexia and a change in bowel habit. Computed tomography (CT) of the chest, abdomen and pelvis demonstrated widespread thoracic and abdominal lymphadenopathy and a lesion within the splenic flexure. This was confirmed as an adenocarcinoma after a colonoscopic biopsy. A CT guided biopsy of the abdominal lymph node confirmed the adenocarcinoma. Within three days of admission, the patient developed worsening, progressive cerebellar symptoms that left the patient aphasic and bed bound. CT of the head was reported as normal. Magnetic resonance imaging of the head demonstrated widespread leptomeningeal metastases. We describe a case of isolated leptomeningeal metastasis from a colorectal primary tumour.