To the Editor.—
Meningeal carcinomatosis (MC) often occurs with symptoms of diffuse neurologic dysfunction caused by widespread leptomeningeal involvement by malignant cells, which, in the purest form, may exist without metastasis elsewhere in the CNS.1 Various degrees of sensorial depression are encountered and may, in some cases, be attributed to increased intracranial pressure with hydrocephalus.2 Recently, Brandt et al3 noted sharply elevated β-endorphin levels in a child with severe necrotizing encephalitis. They concluded that this hyperendorphin state might explain the patient's episodes of depressed ventilatory drive with periods of apnea, along with waxingand-waning levels of consciousness. We were interested to see if β-endorphin might play a role in the sensorial depression of MC.
Report of a Case.—
A 53-year-old woman whose condition was diagnosed as stage II squamous cell carcinoma of the cervix, which was treated with radiation in 1973, had progressive bilateral lower extremity lymphedema and