Meningeal Carcinomatosis

Abstract

In 29 cases of meningeal carcinomatosis reviewed, the widespread involvement of the cranial and spinal leptomeninges produced a complex neurological picture that made the diagnosis difficult. Examination of cerebrospinal fluid was the most helpful diagnostic procedure; the fluid often had decreased glucose and an increased protein content and contained malignant cells. Diffuse leptomeningeal and craniospinal nerve root infiltration was a consistent postmortem finding. The propensity of adenocarcinoma to metastasize in this fashion is reflected by the high frequency of this histologic type in this series. The two commonest primary sites were the breast and lung. In all patients there was progressive clinical deterioration; the average survival after diagnosis was only six weeks.