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Neoplastic meningitis

Last updated: November 24, 2020

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Neoplastic meningitis refers to infiltration of the meninges by tumor cells. It affects approximately 5% of all patients with cancer. Based on the origin of the primary tumor, the condition may be categorized as carcinomatous, lymphomatous, or leukemic meningitis. Some clinical features are secondary to elevated intracranial pressure and include headaches, papilledema, and altered mental status. Treatment depends on primary tumor type and the extent of the disease. However, as neoplastic meningitis is usually a sign of advanced disease with systemic spread, the overall prognosis is poor.

References:[1][2][3][4][5][6]

References:[1][3]

MRI and CSF analysis are complementary and therefore used together to diagnose neoplastic meningitis.
References:[1][3]

Neoplastic meningitis is usually a sign of advanced disease with systemic spread, and therefore has a very poor prognosis. The exact course of treatment depends on tumor type, the extent of systemic disease, and the degree of functional impairment. Treatment typically involves a combination of the following:

References:[3]

  1. Demopoulos A. Clinical features and diagnosis of leptomeningeal metastases from solid tumors. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-leptomeningeal-metastases-from-solid-tumors?source=preview&search=neoplastic%20meningitis&language=en-US&anchor=H7301458&selectedTitle=2~150#H7301458.Last updated: August 10, 2016. Accessed: February 14, 2017.
  2. Chamberlain MC, Nolan C, Abrey LE. Leukemic and lymphomatous meningitis: incidence, prognosis and treatment. J Neurooncol. 2005; 75 (1): p.71-83. doi: 10.1007/s11060-004-8100-y . | Open in Read by QxMD
  3. Chamberlain MC. Neoplastic meningitis. Oncologist. 2008; 13 (9): p.967-977. doi: 10.1634/theoncologist.2008-0138 . | Open in Read by QxMD
  4. Leptomeningeal Metastases.
  5. Hochberg E, Hochberg FH. Clinical presentation and diagnosis of secondary central nervous system lymphoma. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-secondary-central-nervous-system-lymphoma.Last updated: April 4, 2016. Accessed: March 1, 2017.
  6. Central Nervous System Complications of Leukemia. http://www3.mdanderson.org/depts/rpi/di/cnsclmi.html. Updated: February 1, 2002. Accessed: March 1, 2017.
  7. UpToDate. http://www.uptodate.com. Updated: January 1, 2012. Accessed: January 1, 2012.