While leptomeningeal disease is still a terminal, late-stage complication, a variety of treatment modalities, such as intrathecal chemotherapeutics and radiation therapy, have improved median survival from 4–6 weeks to 3–6 months.
How is leptomeningeal disease treated?
A combination of surgery, radiation, and chemotherapy treatment improves the prognosis for leptomeningeal disease. Some tumor types are especially sensitive to chemotherapy injected directly into the cerebrospinal fluid, either by lumbar puncture (“spinal tap”) or through a surgically implanted device called an Ommaya.
How do you know if you have leptomeningeal disease?
Symptoms of Leptomeningeal Metastases
Headaches. Nausea (feeling like you’re going to throw up) or vomiting (throwing up) Difficulty thinking. Double vision.
What happens when you have Leptomeningeal disease?
Leptomeningeal disease may also be referred to as carcinomatous meningitis or neoplastic meningitis. Most often with this complication, people have multiple neurological symptoms including visual changes, speech problems, weakness or numbness of one side of the body, loss of balance, confusion, or seizures.
What is the progression of Leptomeningeal disease?
With progression of leptomeningeal metastases, new signs and symptoms appear and pre-existing findings worsen. Patients with underlying solid tu- mors are more likely to present with spinal or radic- ular symptoms, whereas patients with hematologic malignancies more often present with cranial nerve dysfunction.
How common is leptomeningeal disease?
How common are leptomeningeal metastases? Between 5 to 10 out of every 100 people (5 to 10%) who have cancer might develop leptomeningeal metastases. It is most common in people with breast or lung cancer, or melanoma skin cancer.
What does Leptomeningeal mean?
Leptomeningeal: Having to do with the leptomeninges, the two innermost layers of tissues that cover the brain and spinal cord. Leptomeningeal metastasis refers to cancer that has spread from the original (primary) tumor to the leptomeninges.
What is Leptomeningeal spread?
Leptomeningeal metastases (LM) occur when cancer spreads to the membranes lining the brain and spinal cord. The leptomeninges are the membranes lining the brain and spinal cord. The cerebrospinal fluid (CSF) lies in between these membranes.
Is leptomeningeal metastases painful?
Cancer that spreads to the fluid and tissues surrounding the brain and spinal cord can have devastating effects. The condition, called leptomeningeal metastasis, may cause pain, seizures, difficulty thinking, and a loss of muscle, bowel, and bladder control.
Can Leptomeningeal be benign?
Although rare, local recurrence or leptomeningeal spread of meningeal melanocytoma secondary to malignant transformation has been reported years after the initial diagnosis (2-4). In a literature review, there was only one case report of a meningeal melanocytoma causing a diffuse benign leptomeningeal spread.
What does Leptomeningeal disease look like on an MRI?
On MRI, leptomeningeal enhancement is characterized by high signal intensity within the subarachnoid space of the sulci and cisterns on post-contrast T1 weighted images.
What causes leptomeningeal carcinomatosis?
Causes. Leptomeningeal carcinomatosis occurs when the cancer cells invade the cerebrospinal fluid and spread throughout the central nervous system. The metastatic tumor cells grow either attached to the pia mater covering the brain and spinal cord or floating unattached to the subarachnoid space.
Has Leptomeningeal Carcinomatosis survived?
All cases had a progression-free survival of at least 6 months, with some well over 24 months, which is longer than the documented average LC from breast cancer. Most of these patients also received prior systemic chemotherapy for systemic disease control.
What is leptomeningeal melanoma?
Leptomeningeal metastasis, also known as carcinomatous meningitis, occurs secondary to the dissemination of cancer cells into the pia-arachnoid meninges and/or cerebrospinal fluid. Leptomeningeal disease most commonly occurs in patients with melanoma and lung cancer (Pape et al., 2012; Raizer et al., 2008).
Which Meninge is closest to the brain?
The middle layer of the meninges is called the arachnoid. The inner layer, the one closest to the brain, is called the pia mater or just the pia.
What is leptomeningeal lymphoma?
Primary leptomeningeal lymphoma is a rare form of primary CNS lymphoma. Patients usually present with multifocal symptoms, with evidence of leptomeningeal enhancement and diagnostic CSF analysis. Although treatment is highly variable, patients have a better prognosis than previously reported and a subset may be cured.
Where are the Leptomeninges?
Leptomeninges: The two innermost layers of tissue that cover the brain and spinal cord. The two layers are called the arachnoid mater and pia mater.
What is diffuse Leptomeningeal Glioneuronal tumor?
Diffuse leptomeningeal disseminated glioneuronal tumor (DL-GNT) is a rare brain tumor that presents as a plaque-like subarachnoid tumor, commonly involving the basal cisterns and interhemispheric fissure of children but lacking intraparenchymal tumor.
What is leptomeningeal sarcoidosis?
Leptomeningeal sarcoidosis is usually seen as a thickening and enhancement of the leptomeninges and affects the suprasellar and frontal basal meninges most frequently. In some cases, leptomeningeal disease may spread along perivascular spaces resulting in intraparenchymal involvement.
How does medulloblastoma spread?
Medulloblastoma tends to spread through cerebrospinal fluid (CSF) — the fluid that surrounds and protects your brain and spinal cord — to other areas around the brain and spinal cord. This tumor rarely spreads to other areas of the body.
Which of the following anatomical sites is the most common location for leptomeningeal metastasis to occur *?
The vast majority of leptomeningeal metastases occur in the context of widespread metastatic disease, likely by hematogenous spread. Over 50% of cases have concurrent brain (parenchymal) metastases 13. The most common primary sites are: breast cancer (particularly infiltrating lobular carcinoma)
Do brain Mets cause seizures?
Brain tumors and metastases can cause seizures by a variety of mechanisms; alterations in excitatory neurotransmission and extracellular ion currents are considered the most likely .
What causes meningeal disease?
Meningeal syndrome may be caused by blood, cancer cells, or substances from the breakdown of cancer cells that get into the cerebrospinal fluid (CSF). It may also be caused by infection with a bacterium, virus, or fungus.