Abstract
The authors review the clinical and diagnostic aspects involved in leptomeningeal disease due to solid tumours, leukaemias and lymphomas. The importance of the combination of clinical findings with cerebral spinal fluid (CSF) examination and imaging studies in making an early diagnosis is underlined. The raising prevalence of this complication of systemic cancer deserves specific attention on the part of neurologists involved in consultation liason with general medicine and oncology.
Sommario
Gli Autori revisionano gli aspetti clinici e strumentali coinvolti nella diagnosi di diffusione meningea sia di tumori solidi che di leucemie o linfomi. Viene sottolineata l'importanza dell' associazione di reperti clinici, esame del liquor cefalorachidiano e dati radiologici per consentire una diagnosi precoce. La crescente prevalenza di questa complicazione del cancro disseminato richiede particolare attenzione da parte del neurologo impeganto nella consultazione in medicina generale e in oncologia.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Avoid common mistakes on your manuscript.
References
Posner JB (1995) Leptomeningeal metastases. In: JB Posner (ed) Neurologic complications of cancer. FA Davis, Philadelphia, pp 143–168
Eberth CJ (1870) Zur entwickelung des epithelioms (cholesteatoms) der Pia und der lunge. Virchows Arch 49:51–63
Grain GO, Karr JP (1995) Diffuse leptomeningeal carcinomatosis. Clinical and pathological characteristics. Neurology 7:706–722
Posner JB, Chernik NL (1978) Intracranial metastases from systemic cancer. Adv Neurol 19:575–587
Gonzales-Vitale JC, Garcia-Bunnel R. (1976) Meningeal carcinomatosis. Cancer 37:2906–2911
Takakura K, Sano K, Hojo S et al (1982) Metastatic tumours of the central nervous system. Igakushoin, Tokyo
Rosen ST, Aisner J, Makuch RW et al (1982) Carcinomatous leptomeningitis in small cell lung cancer: a clinicopathological review of the National Cancer Institute experience. Medicine 61:45–53
Nugent JL, Bunn Jr PA, Matthews MJ et al (1979) Central nervous system metastases in small cell bronchogenic carcinoma. Increasing frequency and changing patterns with lengthening survival. Cancer 44:885–1893
Bunn PA, Schein PS, Banks PM, DeVita VT Jr (1996) Central nervous system complications in patients with diffuse histiocytic and undifferentiated lymphoma: leukaemia revisited. Blood 47:3–9
Griffin JW, Thomson RW, Mitchinson MJ, De Kiewiet JC, Welland FH (1971) Lymphomatous leptomeningitis. Am J Med 51:200–208
Levitt LJ, Dawson DM, Rosenthal DS, Moloney WC (1980) Central nervous system involvement in the non-Hodgkin's lymphomas. Cancer 45:545–552
Tsukada Y, Fuad A, Pickren JW et al (1983) Central nervous system metastases from breast carcinoma. Autopsy study. Cancer 52:2349–2354
Boogerd W, Hart AAM, Van der Sande JJ, Engelsman E (1991) Meningeal carcinomatosis in breast cancer. Prognostic factors and influence of treatment. Cancer 67:1685–1695
Freilich RJ, Seidman AD, DeAngelis L (1995) Central nervous system progression of metastatic breast cancer in patients treated with paclitaxel. Cancer 76:232–236
Marsa GW, Johnson RE (1971) Altered patterns of metastases following treatment of Ewing's sarcoma with radiotherapy and adjuvant chemotherapy. Cancer 27:1051–1054
Nies BA, Thomas LB, Freireich EJ (1965) Meningeal leukaemia. A follow-up study. Cancer 18:546–553
Evans AE, Gilbert ES, Zandstra R (1970) The increasing incidence of central nervous system leukaemia in children. Cancer 26:404–409
Wolk RW, Masse SR, Conklin R, Freireich EJ (1974) The incidence of central nervous system leukemia in adults with acute leukaemia. Cancer 33:863–869
Wasserstrom WR, Glass JP, Posner JB (1982) Diagnosis and treatment of leptomeningeal metastases from solid tumours: experience with 90 patients. Cancer 49:759–772
Kaplan JG, De Souza TG, Farkash H et al (1990) Leptomeningeal metastases: Comparison of clinical features and laboratory data of solid tumours, lymphomas and leukemias. J Neurooncol 9:225–229
Yap HY, Yap BS, Tashima CK, Di Stefano A, Blumenschein GR (1978) Meningeal carcinomatosis in breast cancer. Cancer 42:283–286
Schweinle JE, Alperin JB (1980) Central nervous system recurrence ten years after remission of acute lymphoblastic leukemia. Cancer 45:16–18
Olson ME, Chernik NL, Posner JB (1974) Infiltration of the leptomeninges by systemic cancer: A clinical and pathological study. Arch Neurol 30:122–137
Kokkoris CP (1983) Leptomeningeal carcinomatosis. How does cancer reach the pia-arachnoid? Cancer 51:154–160
Simone J, Aur RJA, Husto HO, Pinkel D (1977) “Total therapy” studies of acute lymphocytic leukemia in children. Current results and prospects for cure. Cancer 30:1488–1494
Price RA, Johnson WW (1973) The central nervous system in childhood leukaemia: I. The arachnoid. Cancer 31:520–533
Sause WT, Crowley J, Eyre HJ et al (1988) Whole brain irradiation and intrathechal methotrexate in the treatment of solid tumor leptomeningeal metastases — a Southwest Oncology Group Study. J Neurooncol 6:197–212
Chamberlain MC (1995) Comparative spine imaging in leptomeningeal metastases. J Neurooncol 23:233–238
Little JR, Dale AJD, Okazaki H (1974) Meningeal carcinomatosis. Clinical manifestations. Arch Neurol 30:138–143
Lachance DH, O'Neill BP, MacDonald DR et al (1991) Primary leptomeningeal lymphoma: Report of 9 cases, diagnosis with immunocytochemical analyses and review of literature. Neurology 41:95–100
Silbert SW, Smith KR Jr, Horenstein S (1978) Primary leptomeningeal melanoma. An ultrastructural study. Cancer 41:519–527
Aichner F, Schuler G (1982) Primary leptomeningeal melanoma. Diagnosis by ultrastructural cytology of cerebrospinal fluid and cranial computed tomography. Cancer 50:1751–1756
Smith MT, Armbrustmacher VM, Violett TW (1981) Diffuse meningeal rhabdomyosarcoma. Cancer 47:2081–2086
Smith DB, Howell A, Harris M et al (1985) Carcinomatous meningitis associated with infiltrating lobular carcinoma of the breast. Eur J Surg Oncol 11:33–36
Theodore WH, Gendelman S (1981) Meningeal carcinomatosis. Arch Neurol 38:696–699
Aisner J, Aisner SC, Ostrow S et al (1979) Meningeal carcinomatosis from small cell carcinoma of the lung. Consequence of improved survival. Acta Cytol 23:292–296
Mitchell MS (1989) Relapse in the central nervous system in melanoma patients sucessfully treated with biomodulators. J Clin Oncol 7:1701–1709
Savitz Mh, Anderson PJ (1974) Primary melanoma of the leptomeninges: A review. Mt Sinai J Med 41:774–791
Arnheim FK (1948) Carcinoma of the prostate: A study of post-mortem findings in one hundred and seventy-six cases. JUrol 60:599–603
Hussein AM, Savaraj N, Feun LG, Genjei P, Donnelly E (1989) Carcinomatous meningitis from transitional cell carcinoma of the bladder: Case report. J Neurooncol 7:255–260
Mandell S, Wernez J, Morales P, Weinberg H, Steinfeld A (1985) Carcinomatous meningitis from transitional cell carcinoma of the bladder. Urology 25:520–521
Weed JC Jr, Creasman WT (1975) Meningeal carcinomatosis secondary to advanced squamous cell carcinoma of the cervix: A case report. Meningeal metastasis of advanced cervical cancer. Gynecol Oncol 3:210–214
Benham K, Aguilera AJ, Kornfeld M, Jordan SW, Hilgers RD (1984) Meningeal carcinomatosis from an ovarian primary: A clinocopathological study. Gynecol Oncol 19:104–109
Cormio G, Maneo A, Parma G, Pittelli MR, Miceli MD, Bonazzi C (1995) Central nervous system metastases in patients with ovarian carcinoma. A report of 23 cases and a literature review. Ann Oncol 6:571–574
Redman BG, Tapazoglou E, Al Sarraf M (1986) Meningeal carcinomatosis in head and neck cancer. Report of six cases and review of the literature. Cancer 58:2656–2661
Barnard RO, Parsons M (1986) Carcinoma of the thyroid with leptomeningeal dissemination following the treatment of a toxic goitre with 131-I and methyl thiouracil. Case with a coexisting intracranial dermoid. J Neurol Sci 8:299–306
Bresalier RS, Karlin DA (1979) Meningeal metastases from rectal carcinoma with elevated cerebrospinal fluid carcinoembryogenic antigen. Dis Colon Rectum 22:216–217
Nagourney RA, Hedaya R, Linnoila M et al (1985) Carcinoid carcinomatous meningitis. Ann Intern Med 102:779–782
Patchell RA, Posner JB (1986) Neurologic complications of carcinoid. Neurology 36:745–749
Berry MP, Jenkin RD (1981) Parameningeal rhabdomyosarcoma in the young. Cancer 48:281–288
Mackintosh FR, Colby TV, Podolski WJ et al (1982) Central nervous system involvement in non-Hodgkin's lymphoma: An analysis of 105 cases. Cancer 49:586–595
Ersboll J, Schultz HB, Thomsen BL et al (1985) Meningeal involvement in non-Hodgkin's lymphoma: Symptoms, incidence, risk factors and treatment. Scand J Haematol 35:187–196
Hoerni-Simon G, Suchaud JP, Eghbali H et al (1987) Secondary involvement of the central nervous system in malignant non-Hodgkin's lymphoma. A study of 30 cases in a series of 498 patients. Oncology 44:98–101
Chamberlain MC, Kormanik PA (1996) Prognostic significance of 111-indium-DTPA cerebrospinal fluid flow studies in leptomeningeal metastases. Neurology 46:1674–1677
Bender BI, Mayernick DG (1986) Hodgkin's disease presenting with isolated craniospinal involvement. Cancer 58:1745–1748
Recht L, Straus DJ, Cirrincione C et al (1988) Central nervous system metastases from non-Hodgkin's lymphoma: Treatment and prophylaxis. Am J Med 84:425–435
Dekker AW, Elderson A, Punt K et al (1985) Meningeal involvement in patients with acute nonlymphocytic leukemia. Incidence, management and predictive factors. Cancer 56:2078–2082
Cash J, Fheir KM, Pollack SM (1987) Meningeal involvement in early stage chronic lymphocytic leukemia. Cancer 59:798–800
Maldonado JE, Kyle RA, Ludwig J et al. (1970) Meningeal myeloma. Arch Intern Med 126:660–663
Hauch TW, Shelbourne JD, Cohen HJ et al (1975) Meningeal mycosis fungoides: Clinical and cellular characteristics. Ann. Intern Med 82:499–505
Lundberg WB, Cadman EC, Skeel RT (1976) Leptomeningeal mycoses fungoides. Cancer 38:2149–2152
Stewart DJ, Keating MJ, McCredit KB (1981) Natural history of central nervous system acute leukaemia in adults. Cancer 47:184–196
Chamberlain MC (1994) Pediatric leptomeningeal metastasis: 111-indium-DTPA cerebrospinal fluid flow studies. J Child Neurol 9:150–154
Vertosick FT, Selker RG (1990) Brain stem and spinal metastases of supratentorial glioblastoma multiforme: A clinical series. Neurosurgery 27:516–522
Hitchins RN, Bell DR, Woods RL et al (1987) A prospective randomised trial of single agent versus combination chemotherapy in meningeal carcinomatosis. J Clin Oncol 5:1655–1662
Freilich RJ, Krol G, De Angelis LM (1995) Neuroimaging and cerebrospinal fluid cytology in the diagnosis of leptomeningeal metastasis. Ann Neurol 38:51–57
Grossman SA, Moynhian TJ (1991) Neoplastic meningitis. Neurol Clin 9:843–857
De Angelis LM, Payne R (1987) Lymphomatous meningitis presenting as atypical cluster headache. Pain 30:211–216
Weitzner MA, Olofsson SM, Forman AD (1995) Patients with malignant meningitis presenting with neuropsychiatric manifestations. Cancer 76:1804–1808
Broderick JP, Cascino TL (1987) Nonconvulsive status epilepticus in a patient with leptomeningeal cancer. Mayo Clin Proc 62:835–837
Dexter DD Jr, Westmoreland BF, Cascino TL (1990) Complex partial status epilepticus in a patient with leptomeningeal carcinomatosis. Neurology 40:858–859
Yap HY, Tashima CK, Blumenschein GR et al (1979) Diabetes insipidus in breast cancer. Arch Intern Med 139:1009–1011
Houck WA, Olson KB, Horton J (1970) Clinical features of tumor metastasis to the pituitary. Cancer 26:656–659
Tham LC, Millward MJ, Lind MJ et al (1992) Metastatic breast cancer presenting with diabetes insipidus. Letter to the editor. Acta Oncol 31:679–683
Ra'anani P, Shpilberg O, Berezin M et al (1994) Acute leukemia relapse presenting as central diabetes insipidus. Cancer 73:2312–2316
Madow I, Alpers BJ (1951) Encephalitic form of metastatic carcinoma. Arch Neurol Psych 65:161–173
Floeter MK, So YT, Ross DA et al (1987) Miliary metastases to the brain: Clinical and radiological features. Neurology 37:1817–1818
Miller JW, Klass DW, Mokri B et al (1986) Triphasic waves in cerebral carcinomatosis. Another nonmetabolic cause. Arch Neurol 43:1191–1193
Oster JR, Perez GO, Larios O et al (1983) Cerebral salt wasting in a man with carcinomatous meningitis. Arch Intern Med 143:2187–2188
Karp G, Nahum K (1992) Hyperventilation as the initial manifestation of lymphomatous meningitis. J Neurooncol 13:173–175
Houck JR, Murphy K (1992) Sudden bilateral profound hearing loss resulting from meningeal carcinomatosis. Otolaryngol Head Neck Surg 106:92–97
Altrocchi PH, Eckman PB (1973) Meningeal carcinomatosis and blindness. J Neurol Neurosurg Psychiatry 36:206–210
Kattah JC, Suski ET, Killen JY et al (1980) Optic neuritis and systemic lymphoma. Am J Ophthalmol 89:431–436
Boogerd W, Moffie D, Smets LA (1990) Early blindness and coma during intrathecal therapy for meningeal carcinomatosis. Cancer 65:452–457
Oshiro H, Perlman HB (1965) Subarachnoid spread of tumor to the labyrinth. Arch Otolaryngol 81:328–334
La Venuta F, Moore JA (1972) Involvement of the inner ear in acute stem cell leukemia. Report of two cases. Ann Otol Rhinol Laryngol 81:132–137
Civantos F, Choi YS, Applebaum EL (1992) Meningeal carcinomatosis producing bilateral sudden hearing loss: A case report. Am J Otol 13:369–371
Ingram LC, Fairelough DL, Furman WL et al (1991) Cranial nerve palsy in childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma. Cancer 67:2262–2268
Wilkins DE, Samhouri AM (1979) Isolated bilateral oculomotor paresis due to lymphoma. Neurology 29:1425–1428
Van Rossum J, Zwaan FE, Bats GT (1979) Facial palsy as the initial symptom of lymphoreticular malignancy. Case Report. Eur Neurol 18:2121–2126
Parsons M (1972) The spinal form of carcinomatous meningitis. QJM 41:509–519
Sudarsky L, Ronthal M (1983) Gait disorders among elderly patients. A survey of 50 patients. Arch Neurol 40:740–743
Glass JP, Melamed M, Chernick NL, Posner JB (1979) Malignant cells in the cerebrospinal fluid (CSF): The meaning of positive cerebrospinal fluid cytology. Neurology 29:1369–1375
Mahmoud HH, Rivera GK, Hancock ML et al (1993) Low leukocyte counts with blast cells in cerebrospinal fluid of children with newly diagnosed acute lymphoblastic leukemia. N Engl J Med 329:312–319
Van Uitert RL, Eisenstadt ML (1978) Venous pulsations not always indicative of normal intracranial pressure. Letter to the Editor. Arch Neurol 35:550
King DK, Loh KK, Ayala AG et al (1975) Eosinophilic meningitis and lymphomatous meningitis. Letter to the Editor. Ann Intern Med 82:228
Mulligan MJ, Vasu R, Grossi CE et al (1988) Case report: Neoplastic meningitis with eosinophilic pleocytosis in Hodgkin's disease: A case with cerebellar dysfunction and a review of the literature. Am J Med Sci 296: 22–326
Budka H, Guseo A, Jellinger K et al (1976) Intermittent meningitic reaction with severe basophilia and eosinophilia in central nervous system leukemia. J Neurol Sci 28:459–468
Quinn JP, Weinstein RA, Caplan LR (1984) Eosinophilic meningitis and ibuprofen therapy. Neurology 34:108–109
Lossos A, Siegel T (1992) Spinal subarachnoid hemorrhage associated with leptomeningeal metastases. J Neurooncol 12:167–171
Siegal T, Shorr J, Lubetzki Korn I et al (1981) Myeloma protein synthesis within the central nervous system by plasma cell tumors. Ann Neurol 10:271–273
Schipper HI, Bardosi A, Jacobi C et al (1988) Meningeal carcinomatosis: Origin of local IgG production in CSF. Neurology 38:413–416
Libshitz HI, Jing BS, Wallace S et al (1983) Sterilized metastases: A diagnostic and therapeutic dilemma. AIR Am J Roentgenol 140:15–19
Nagakawa H, Yamada M, Kanayama T et al (1994) Myelin basic protein in the cerebrospinal fluid of patients with brain tumors. Neurosurgey 34:825–833
Yap HY, Yap BS, Rasmussen S, Levens ME, Hortobagyi GN, Blumenschein GR (1983) Treatment for meningeal carcinomatosis in breast cancer. Cancer 49:219–222
De Vita VT, Canellos GP (1966) Hypoglycorrhachia in meningeal carcinomatosis. Cancer 19:691–694
An-Foraker SH (1985) Cytodiagnosis of malignant lesions in cerebrospinal fluid. Review and cytohistologic correlation. Acta Cytol 29: 286–290
Lauer SJ, Kirchner PA, Camitta BM (1989) Identification of leukemic cells in the cerebrospinal fluid from childern with acute lymphoblastic leukemia. Advances and dilemma. Am J Pediatr Hematol Oncol 11:64–73
Rossi M, Morena M, Tognetti P, Zanardi M (1995) Meningite carcinomatosa. Presentazione di 3 casi. Recenti Prog Med 86:159–163
Murray JJ, Greco FA, Wolff SN et al (1983) Neoplastic meningitis. Marked variation of cerebrospinal fluid composition in the absence of extradural block. Am J Med 75:289–294
Rogers LR, Duchesneau PM, Nunez C et al (1992) Comparison of cisternal and lumbar cerebrospinal fluid examination in leptomeningeal metastases. Neurology 42:1239–1241
Choi HSH, Anderson PJ (1979) Diagnostic cytology of cerebrospinal fluid by the cytocentrifuge method. Am J Clin Pathol 72:931–943
Schumann GB, Crisman LG (1985) Cerebrospinal fluid cytopathology. Clin Lab Med 5:275–302
Seyfert S, Kabbeck Kupijai D, Marx P et al (1992) Cerebrospinal fluid cell preparation methods. An evaluation. Acta Cytol 36:927–931
Moseley RP, Oge K, Shafqats S et al (1989) HMFGI antigen: A new marker for carcinomatous meningitis. Int J Cancer 44:440–444
Hovestadt A, Henzen-Logmans SC, Vecht CJ (1990) Immunohistochemical analysis of the cerebrospinal fluid for carcinomatous and lymphomatous leptomeningitis. Br J Cancer 62:653–654
Lange BJ, Rovera G (1991) Detection of minimal residual leukaemia in acute lymphoblastic leukaemia. Hematol Oncol Clin North Am 4:845–995
Cibas ES, Malkin MM, Posner JB, Melamed MR (1990) Detection of DNA abnormalities by flow cytometry in cells from cerebrospinal fluid. Am J Clin Pathol 88:570–577
Dux R, Kindler Rohrbon A, Annas M et al (1994) A standardized protocol for flow cytometric analysis of cells isolated from cerebrospinal fluid. J Neurol Sci 121:74–78
Granberg Ohman IF, Andersson BI, Gupta SK et al (1979) Chromosome analysis in meningeal carcinomatosis. Acta Neurol Scand 60:255–259
Gangji D (1992) Treatment of leptomeningeal metastases. In: Hildebrandt J (ed) Management in neuro-oncology. SpringerVerlag, Berlin Heidelberg New York, pp 41–62
Kappel TJ, Manivel KC, Goswitz JJ (1994) Atypical lymphocytes in spinal fluid resembling post-transplant lymphoma in a cardiac transplant recipient: A case report. Acta Cytol 38:470–474
Ezrin Waters C, Klein M, Deck J et al (1984) Diagnostic importance of immunological markers in lymphoma involving the central nervous system. Ann Neurol 16:668–672
Li CY, Witzig TE, Phyliky RL et al (1986) Diagnosis of B-cell non-Hodgkin's lymphoma of the central nervous system by immunocytochemical analysis of cerebrospinal fluid lymphocytes. Cancer 57:734–744
Kranz BR, Thierfelder S, Gerl A et al (1992) Cerebrospinal fluid immunocytology in primary central nervous system lymphoma. Letter to the editor. Lancet 340:727
Balhuizen JC, Bots GT, Scaberg A et al (1978) Value of cerebrospinal fluid cytology for the diagnosis of malignancies in central nervous system. J Neurosurg 48:747–753
Cheng TM, O'Neill BP, Scheitauer BW et al (1994) Chronic meningitis: The rule of meningeal or cortical biopsy. Neurosurgery 34:590–596
Olinger CP, Ohlhaber RL (1974) Eighteen gauge microscopic telescopic needle endoscope with electrode channel: Potential clinical and research application. Surg Neurol 2:151–160
Coakham HB, Garson JA, Brownell B et al (1984) Use of monoclonal antibody panel to identify malignant cells in cerebrospinal fluid. Lancet 1:1095–1098
Garson JA, Coakham HB, Kemshead JT et al (1985) The role of monoclonal antibodies in brain tumour diagnosis and cerebrospinal fluid (CSF) cytology. J Neurooncol 3:165–171
Boogerd W, Vroom TM, Van Heerde PV et al (1988) Cerebrospinal fluid cytology versus immunocytochemistry in meningeal carcinomatosis. J Neurol Neurosurg Psychiatry 51:142–145
Van Zanten AP, Twijnstra A, Hart AAM, Ongerbroer de Visser BW (1986) Cerebrospinal fluid lactate dehydrogenate activities in patients with central system metastases. Clin Chim Acta 161:259–268
Malkin MG, Posner JB (1987) Cerebrospinal fluid markers for the diagnosis and management of leptomeningeal metastases. A review. Eur J Cancer Clin Oncol 23:1–4
Bach F, Soletormos G, Bach FW et al (1990) TPA and CKBB: New tumor markers in leptomeningeal carcinomatosis secondary to breat cancer. Letter to the editor. J Natl Cancer Inst 82:320–322
Van Zanten AP, Twijinstra A, Ongerboer de Visser BW, Van Heerde P, Hart HAM, Nooyen WJ (1991) Cerebrospinal fluid tumour marker in patients treated for meningeal malignancy. J Neurol Neurosurg Psychiatry 54:119–123
Nagakawa H, Kubo S, Murosawa A et al (1992) Measurement of cerebrospinal fluid biochemical tumor markers in patients with meningeal carcinomatosis and brain tumors. J Neurooncol 12:111–120
Yap BS, Yap HY, Fritsche H, Blumenschein G, Bodey JP (1988) Cerebrospinal fluid carcinoembryonic antigen in meningeal carcinomatosis from breast cancer. JAMA 244:600–601
Schold SC, Wasserstrom WR, Fleisher M, Schwartz MK, Posner JB (1980) Cerebrospinal fluid biochemical markers of central nervous system metastases. Ann Neurol 8:597–604
Mencel PJ, De Angelis LM, Motzer RJ (1994) Hormonal ablation as effective therapy for carcinomatous meningitis from prostatic carcinoma. Cancer 73:1892–1894
Ottinger H, Cyrus C, Belka C et al (1994) Meningeal in volvement in acute leukaemia and high grade non-Hodgkin's lymphoma is associated with elevated activities of galactosyltransferases in the cerebrospinal fluid. Onkologie 17:180–183
Mavligit GM, Stuckey SE, Cabanillas FF et al (1980) Diagnosis of leukemia or lymphoma in the central nervous system by beta 2 microglobulin determination. N Engl J Med 303:718–722
Twijinstra A, Ongerboer de Visser BW, Van Zanten AP, Hart AAM, Nooyen WJ (1989) Serial lumbar and ventricular cerebrospinal fluid biochemical marker measurement in patients with leptomeningeal metastases from solid and haematological tumours. J Neurooncol 7:57–63
Hansen PB, Kjeldsen L, Dalhoff K et al (1992) Cerebrospinal fluid beta2 microglobulin in adult patients with acute leukemia or lymphoma: A useful marker in early diagnosis and monitoring of central nervous system involvement. Acta Neurol Scand 85:224–227
Peterslund NA, Black FT, Geil JP et al (1989) Beta 2 microglobulin in the cerebrospinal fluid of patients with infections of the central nervous system. Acta Neurol Scand 80:579–583
Shuttleworth E, Allen N (1980) Cerebrospinal fluid beta-glucoronidase assay in the diagnosis of neoplastic meningitis. Arch Neurol 37:684–687
Tallman RD, Kimbrough SM, O'Brien JF et al (1985) Assay for beta glucoronidases in cerebrospinal fluid: Usefulness for the detection of neoplastic meningitis. Mayo Clin Proc 60:293–298
Wasserstrom WR, Schwartz MK, Fleisher M, Posner JB (1981) Cerebrovascular fluid biochemical markers in the central nervous system tumours: A review. Ann Clin Lab Sci 11:239–251
Lampl Y, Paniri Y, Eshel Y et al (1990) Alkaline phospatase level in cerebrospinal fluid in various brain tumors and pulmonary carcinomatous meningitis. J Neurooncol 9:35–40
Milman N, Vig L, Pedersen NS et al (1985) Cerebrospinal fluid ferritin in patients with leukaemia and malignant lymphoma. Scand J Haematol 35:132–136
Zandman Goddard G, Matzner Y, Konijin AM et al (1986) Cerebrospinal fluid ferritin in malignant central nervous system involvement. Cancer 58:1346–1349
Newton HB, Fleisher M, Schwartz MK, Malkin MG (1991) Glucosephospate isomers as a cerebrospinal fluid marker for leptomeningeal metastases. Neurology 41:395–398
Mahoney Dh Jr, Fembach DJ, Glaze DG et al (1984) Elevated myelin basic protein levels in the cerebrospinal fluid of children with acute lymphoblastic leukemia. J Clin Oncol 2:58–61
Bach F, Soletormos G, Dombernowsky P (1991) Tissue polypeptide antigen activity in cerebrovascular fluid: A marker of central nervous system metastases of breast cancer. J Natl Cancer Inst 83:779–784
Kaplan JG, Portenoy RK, Pack DR, DeSouza T (1990) Polyradiculopathy in leptomeningeal metastasis: The role of EMG and late response studies. J Neurooncol 9:219–224
Argov Z, Siegal T (1995) Leptomeningeal metastases: Peripheral nerve and root involvement — clinical and electrophysiological study. Ann Neurol 17:593–596
Jaeckle KA, Krol G, Posner JB (1985) Evolution of computed tomographic abnormalities in leptomeningeal metastases. Ann Neurol 17:85–89
Krol G, Sze G, Malkin M, Walker R (1988) MR of cranial and spinal meningeal carcinomatosis. Comparison with CT and myelography. AJR Am J Roentgenol 151:585–588
Lee YY, Glass JP, Geoffray A et al (1984) Cranial computed tomographic abnormalities in leptomeningeal metastases. AJR Am J Roentgenol 143:1035–1039
Yousern DM, Patrone PM, Grossman RI (1990) Leptomeningeal metastases: MR evaluation. J Comput Assist Tomogr 14:255–261
Sze G, Abramson A, Krol G et al (1988) Gadolinium-DTPA in the evaluation of intradural extramedullary spinal disease. AJR Am J Roentgenol 150:911–921
Kramer ED, Rafto S, Packer RJ, Zimmerman RA (1991) Comparison of myelography with CT follow up versus gadolinium MRI for subarachnoid metastatic disease in children. Neurology 41:46–50
Jayson GC, Howell A (1996) Carcinomatous meningitis in solid tumours. Ann Oncol 7: 73–786
Rodesch G, Van Bogaert, Mavroudakis N et al (1990) Neuroradiological findings in leptomeningeal carcinomatosis: The value interest of gadolinium-enhanced MRI. Neuroradiology 32:26–32
Schukneckt B, Huber P, Buller B et al (1992) Spinal leptomeningeal neoplastic disease. Evaluation by myelography and CT myelography. Eur Neurol 32:11–16
Latchaw RE, Gabrielsen TO, Seeger JF (1974) Cerebral angiography in meningeal sarcomatosis and carcinomatosis. Neuroradiology 8:131–139
Klein P, Haley EC, Wooten GF et al (1989) Focal cerebral infarctions associated with perivascular tumor infiltrates in carcinomatous leptomeningeal metastases. Arch Neurol 46:1149–1152
Grossman SA, Trump DL, Chen DCP, Thompson G, Camargo EE (1982) Cerebrospinal fluid flow abnormalities in patients with neoplastic meningitis. An evaluation using 111-indiumDTPA ventriculography. Am J Med 73:641–647
Chamberlain MC, Corey-Bloom J (1991) Leptomeningeal metastases: 111-indium-DTPA cerebrospinal fluid studies. Neurology 41:1765–1769
Glantz MJ, Hall WA, Cole BF et al (1995) Diagnosis, management and survival of patients with leptomeningeal cancer based on cerebrospinal fluid-flow status. Cancer 12:2919–2931
Caraceni A, Martini C (1998) Neurological problems in palliative medicine. In: Hanks G, Mac Donald N, Doyle D (eds) Oxford textbook of palliative medicine, 2nd edn. Oxford University, Oxford, p 731
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Formaglio, F., Caraceni, A. Meningeal metastases: clinical aspects and diagnosis. Ital J Neuro Sci 19, 133–149 (1998). https://doi.org/10.1007/BF00831563
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00831563