Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 5 (5), 443-52

Neoplastic Meningitis

Affiliations
Review

Neoplastic Meningitis

Beate Gleissner et al. Lancet Neurol.

Abstract

Neoplastic meningitis is a complication of the CNS that occurs in 3-5% of patients with cancer and is characterised by multifocal neurological signs and symptoms. Diagnosis is problematic because the disease is commonly the result of pleomorphic manifestations of neoplastic meningitis and co-occurrence of disease at other sites. Useful tests to establish diagnosis and guide treatment include MRI of the brain and spine, cerebrospinal fluid (CSF) cytology, and radioisotope CSF flow studies. Assessment of the extent of disease of the CNS is of value because large-volume subarachnoid disease or CSF flow obstruction is prognostically significant. Radiotherapy is an established and beneficial treatment for patients with neoplastic meningitis with large tumour volume including parenchymal brain metastasis, sites of symptomatic disease, or CSF flow block. Because neoplastic meningitis affects the entire neuraxis, chemotherapy treatment can include intra-CSF fluid (either intraventricular or intralumbar) or systemic therapy. Most patients (>70%) with neoplastic meningitis have progressive systemic disease and consequently treatment is palliative and tumour response is of restricted durability. Furthermore, as there is no compelling evidence of a survival advantage with aggressive multimodal treatment, future trials need be done to determine the effect of treatment on quality of life and control of neurological symptoms.

Similar articles

  • [Neoplastic Meningitis]
    K Hotta et al. Gan To Kagaku Ryoho 38 (4), 515-7. PMID 21498976.
    Neoplastic meningitis(NM)is a common problem in neuro-oncology. Notwithstanding its frequent focal signs and symptoms, NM is a disease affecting the entire neuraxis, and …
  • Neoplastic Meningitis
    MC Chamberlain. Neurologist 12 (4), 179-87. PMID 16832237. - Review
    Although treatment of NM is palliative, with an expected median patient survival of 2 to 6 months, it often affords stabilization and protection from further neurologic d …
  • Neoplastic Meningitis
    MC Chamberlain. Semin Neurol 24 (4), 363-74. PMID 15637648. - Review
    Neoplastic meningitis is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer. Notwithstanding frequent focal signs and symptoms, …
  • Neoplastic Meningitis
    L Kim et al. Curr Treat Options Oncol 2 (6), 517-27. PMID 12057097. - Review
    Neoplastic meningitis is recognized clinically in 4% to 7% of patients with extraneural cancer, but it remains dramatically under-diagnosed. The frequency of neoplastic m …
  • Neoplastic Meningitis
    MC Chamberlain. Oncologist 13 (9), 967-77. PMID 18776058. - Review
    Although treatment of NM is palliative with an expected median patient survival of 2 to 6 months, it often affords stabilization and protection from further neurologic de …
See all similar articles

Cited by 67 PubMed Central articles

See all "Cited by" articles

Publication types

LinkOut - more resources

Feedback