Case Presentation: A 27-year-old man with metastatic gastroesophageal junction adenocarcinoma presents with five weeks of progressively worsening bilateral thigh pain. Admission exam is notable for a normal neurological exam. Labs are notable for CSF with malignant cells. Brain and spine MRI reveal diffuse leptomeningeal carcinomatosis. During his hospitalization, the patient develops dizziness and leg weakness [...]

Case Presentation: A 27-year-old man with metastatic gastroesophageal junction adenocarcinoma presents with five weeks of worsening thigh pain. Labs are notable for CSF with malignant cells. Brain and spine MRI reveal diffuse leptomeningeal carcinomatosis. His course is complicated by severe pain that requires increasing doses of opioids. During his hospitalization, the patient develops worsening headaches, [...]