Leptomeningeal metastasis

Jai Grewal MD (Dr. Grewal of the Long Island Brain Tumor Center at Neurological Surgery, PC, received research funding from Northwest Biotherapeutics and consulting fees from Novocure.)
Harpreet K Grewal MD (Dr. Grewal of JGMDPC in Roslyn, New York, has no relevant financial relationships to disclose; Dr. Grewal's spouse received research funding from Northwest Biotherapeutics and consulting fees from Novocure.)
Edward J Dropcho MD, editor. (Dr. Dropcho of Indiana University Medical Center has no relevant financial relationships to disclose.)
Originally released April 26, 1994; last updated February 2, 2015; expires February 2, 2018

This article includes discussion of leptomeningeal metastasis, carcinomatous meningitis, leptomeningeal carcinoma, meningeal carcinoma, meningeal carcinomatosis, neoplastic meningitis, drop metastases, meningeal lymphomatosis, meningeal gliomatosis, and myelomatous meningitis. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Key points

 

• Leptomeningeal metastasis represents seeding of tumor to cerebrospinal fluid and adjacent coverings.

 

• Clinical hallmarks include involvement of multiple levels of the neuroaxis, such as cranial and lumbosacral nerve dysfunction.

 

• Treatment options are palliative and include radiotherapy, systemic chemotherapy, and intra-CSF chemotherapy.

Historical note and terminology

The first pathological description was by Olliver in 1837, followed by Eberth (Eberth 1870). The first description of carcinoma cells in CSF may be that by Dufour (Dufour 1904). Beerman coined the term "meningeal carcinomatosis" (Beerman 1912). The term “leptomeningeal metastasis” is favored because it includes malignancies other than carcinoma and excludes dural metastasis.

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