Outcome/Follow up
After establishing the presumed diagnosis of neoplastic meningitis, a second high-volume lumbar puncture was performed for CSF cytology, and a bone biopsy was arranged. Sadly, the patient suddenly deteriorated and required palliation. He died four days later.
CSF cytology, returned post-mortem, demonstrated a poorly differentiated adenocarcinoma. Immunohistochemistry staining suggested this was of lung or upper gastrointestinal origin.