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Leptomeningeal Metastases

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Cancer Neurology in Clinical Practice

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Abstract

Cancer cells can invade the cerebrospinal fluid (CSF) and seed the leptomeniges in a diffuse and multifocal manner, producing a complication known as leptomeningeal metastases or seeding. These cancer cells can remain confined to the meninges or penetrate the brain, spinal cord, or nerve roots, leading to a variety of symptoms and neurologic signs. The multiplicity of clinical findings associated with leptomeningeal metastases has made this diagnosis particularly challenging for the clinician. This devastating complication was first described by Eberth in 1870 (1), and later named “meningitis carcinomatosa” by Siefert in 1902 (2). Once considered uncommon and described usually as a finding at autopsy, leptomeningeal metastases has been diagnosed with increasing frequency in recent decades. For this reason, and because of the severe and devastating symptoms caused by this disorder, leptomeningeal metastases has become a common problem in neuro-oncology. Early diagnosis of leptomeningeal metastases is important because recent studies have suggested that intervention is most beneficial for patients who have minimal symptoms, high performance status, and low leptomeningeal tumor burden.

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  1. Warren P. Mason MD, FRCPC
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Editors and Affiliations

  1. Department of Neurology, University of Virginia Medical Center, Charlottesville, VA, USA

    David Schiff MD

  2. Center for Neuro-Oncology Dana-Farber Cancer Institute; and Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA

    Patrick Y. Wen MD

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Mason, W.P. (2003). Leptomeningeal Metastases. In: Schiff, D., Wen, P.Y. (eds) Cancer Neurology in Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-317-0_10

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  • DOI: https://doi.org/10.1007/978-1-59259-317-0_10

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