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Abstract: It has become increasingly evident over the last years that Parkinson''s disease is a multicentric neurodegenerative disease that affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. The aims of the present article are to discuss the role of the enteric nervous system lesions in pathology spreading (Braak''s hypothesis) and in the gastrointestinal dysfunction encountered in Parkinson''s disease. Owing to its accessibility to biopsies, we further discuss the use of the enteric nervous system as an original source of biomarker in Parkinson''s disease. [Copyright &y& Elsevier]

Summary: Introduction: Adenocarcinoma of the ethmoid is an aggressive tumor, with potential extension to surrounding structures. Leptomeningeal extension is a rarely reported entity. Case report: A carpenter, aged 55, developed multifocal cranial nerve-related symptoms 1week after resection of adenocarcinoma of the ethmoid, evolving towards deteriorated general health status and death 10weeks later. Brain MRI showed diffuse contrast enhancement of the cranial nerves, and repeated cerebrospinal fluid (CSF) examination found increased protein concentration associated with decreased glucose concentration, without malignant cells. The diagnosis of carcinomatous meningitis was based on the association of clinical, CSF and brain MRI data. Discussion/conclusion: Leptomeningeal dissemination of adenocarcinoma of the ethmoid is rare; diagnosis is guided by clinical signs. MRI reveals neurological spread, but the presence of malignant cells in the CSF is sufficient for diagnosis. Due to poor prognosis, the only currently available treatments are palliative. [Copyright &y& Elsevier]