Leptomeningeal spread of breast cancer: Report of case and review of the literature

Abstract

Leptomeningeal metastasis--so-called "meningeal carcinomatosis"--of breast carcinoma has become a problem of some magnitude in recent years, in part a result of the increasing use of combination chemotherapy in the treatment of this disease. Early clinical diagnosis, based on the recognition of multifocal neurologic dysfunction, and aggressive therapy combining irradiation to severely symptomatic sites with intrathecal chemotherapy are considered primordial in order to improve the poor prognosis of the untreated lesion. This is especially true in view of the fact that meningeal metastasis often occurs as the sole site of recurrence in an otherwise asymptomatic patient. Hence, relief of neurologic symptoms can provide meaningful palliation and an occasional long-term survivor. If meningeal metastasis continues to increase in breast cancer patients, prophylactic CNS treatment may become a consideration.