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  • Updated 05.23.2023
  • Released 04.26.1994
  • Expires For CME 05.23.2026

Leptomeningeal metastasis


Key points

• Leptomeningeal metastasis represents seeding of tumor cells to the cerebrospinal fluid and leptomeninges (arachnoid and pia mater).

• The clinical hallmarks include involvement of multiple levels of the neuroaxis and nonlocalizable symptoms such as increased intracranial pressure.

• Treatment options include radiotherapy, systemic therapy, and CSF-administered therapy.

Historical note and terminology

The first pathological description was by Olliver in 1837, followed by Eberth (16). The first description of carcinoma cells in CSF may be that by Dufour (15). Beerman coined the term "meningeal carcinomatosis" (07). The term “leptomeningeal disease” or “leptomeningeal metastases” is favored because it includes malignancies other than carcinoma and excludes dural metastasis, although used in describing malignant processes, “leptomeningeal disease” does not directly specify a neoplastic etiology in the term. In turn, leptomeningeal metastases may be the most appropriate term.

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