Leptomeningeal metastasis

Iyad Alnahhas MD MSc (

Dr. Alnahhas of Thomas Jefferson University has no relevant financial relationships to disclose.

Rimas V Lukas MD, editor. (

Dr. Lukas of Northwestern University Feinberg School of Medicine received honorariums from Novocure for speaking engagements, honorariums from Novocure for advisory board membership, and research support from BMS.

Originally released April 26, 1994; last updated October 24, 2020; expires October 24, 2023

Key points


• Leptomeningeal metastasis represents seeding of tumor cells to the cerebrospinal fluid and leptomeninges.


• Clinical hallmarks include involvement of multiple levels of the neuroaxis, such as increased intracranial pressure and cranial and spinal nerve coating leading to dysfunction.


• Treatment options include radiotherapy, systemic therapy, 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 disease” or “leptomeningeal metastases” is favored because it includes malignancies other than carcinoma and excludes dural metastasis.

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