Leptomeningeal metastasis

Historical note and nomenclature
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By Jai Grewal MD and Harpreet K Grewal MD

Leptomeningeal metastasis is also known as Carcinomatous meningitis, Drop metastases, Meningeal carcinomatosis, Meningeal lymphomatosis, Meningeal gliomatosis, and Myelomatous meningitis.

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.

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.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
References cited
Contributors