J Korean Cancer Assoc.  2001 Feb;33(1):34-40.

Leptomeningeal Carcinomatosis in Solid Tumors; Clinical Manifestation and Treatment

Affiliations
  • 1Yonsei Cancer Center.
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

PURPOSE: Leptomeningeal carcinomatosis occurs in about 5% of patients with solid tumor and is being diagnosed with increasing frequency as patients live longer and as neuro-imaging studies improve. In general, the most commom cancers that involved the leptomeninges are breast cancer, lung cancer, and malignant melanoma.
MATERIALS AND METHODS
We investigated 25 patients presented with multiple neurologic symptoms and signs who were diagnosed with leptomeningeal carcinomatosis at the Yonsei Cancer Center from January 1990 to December 1999.
RESULTS
The primary disease of leptomeningeal carcinomatosis were stomach cancer (10 cases), breast cancer (7 cases), lung cancer (5 cases), unknown primary cancer (2 cases) and common bile duct cancer (1 case). All patients were presented with multiple neurologic symptoms and signs involving the central nervous system (CNS), cranial nerve or spinal nerves. Twenty-one of twenty- five patients were treated with intrathecal chemotherapy, radiotherapy, or combination therapy. Fourteen of them (66.7%) experienced improvement or stabilization of neurologic symptom and sign. The median survival was 122 days (10-2190).
CONCLUSION
In conclusion, although early diagnosis and active treatment of leptomeningeal carcinomatosis may improve the quality of life in selected patients, the median survival was relatively short. Therefore, new diagnostic and therapeutic strategy for leptomeningeal carcinomatosis were needed.

Keyword

Leptomeningeal carcinomatosis; Intrathecal chemotherapy; Radiotherapy

MeSH Terms

Breast Neoplasms
Central Nervous System
Common Bile Duct
Cranial Nerves
Drug Therapy
Early Diagnosis
Humans
Lung Neoplasms
Melanoma
Meningeal Carcinomatosis*
Neurologic Manifestations
Quality of Life
Radiotherapy
Spinal Nerves
Stomach Neoplasms
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