- Most common tumors metastasize to meninges are breast, lung, melanoma
- No identifiable primary malignancy in 2-4% of cases
- Headache is the most common presenting symptom.
- Diagnosis relies on cytological examination (CSF cytology or leptomeningeal biopsy). CSF markers and radiographic findings also can strongly support diagnosis.
- Short median survival even with aggressive treatment
- Meningeal enhancement
- Thick, clumped nerve roots
- Enhancing nodular deposits on surface of roots or CNS structures
- Coexisting parenchymal, epidural or bony metastases
Balm M, et al. Leptomeningeal carcinomatosis: presenting features and prognostic factors. Arch Neurol 1996 (July 1996).