Chapter

Leptomeningeal Metastases

Lisa M. Deangelis and Jerome B. Posner

in Neurologic Complications of Cancer

Second edition

Published on behalf of Oxford University Press

Published in print September 2008 | ISBN: 9780195366747
Published online April 2013 | e-ISBN: 9780199322879 | DOI: http://dx.doi.org/10.1093/med/9780195366747.003.0007

Series: Contemporary Neurology Series

Leptomeningeal Metastases

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Cancer cells that metastasize to any part of the nervous system in contact with the cerebrospinal fluid (CSF) may be shed into the CSF and float along CSF pathways to other areas of the nervous system where they may settle and grow (Fig. 7–1). These cells may seed the meninges focally, multifocally, or diffusely. The resulting leptomeningeal tumor may be visible grossly or only on microscopic examination. The tumor can remain within the meninges or invade the parenchyma of the brain, spinal cord, or cranial or peripheral nerves. The terms applied to this disorder have varied. When the primary disease is leukemia, the term “meningeal leukemia” is generally used.1,2 When the primary tumor is not leukemia, the general term “meningeal carcinomatosis”3 has been applied, even if the tumor is a lymphoma or sarcoma. The terms “carcinomatous meningitis”4 or “neoplastic meningitis”5,6 are frequently used misnomers that suggest a leptomeningeal inflammatory response, which may or may not accompany tumor in the CSF.7 The terms “leptomeningeal seeding” or “leptomeningeal metastases”8,9 seem more appropriate.

Chapter.  21942 words.  Illustrated.

Subjects: Neurology

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