Journal of Neuro-Oncology

, Volume 9, Issue 3, pp 225–229

Leptomeningeal metastases: Comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias

  • Jerry G. Kaplan
  • Trevor G. DeSouza
  • Arthur Farkash
  • Bronislava Shafran
  • Daniel Pack
  • Faroog Rehman
  • Joachim Fuks
  • Russell Portenoy
Clinical Study

Abstract

We reviewed 63 cases of cytologically confirmed leptomeningeal metastases (LM). 31 (49%) had solid tumors 17 (27%) had leukemia and 15 (24%) had lymphoma.

The most common presenting symptom was pain (76%) with radicular discomfort (58%), headache (32%), neck or back pain (17%). The predominant neurological signs were mental status abnormalities (49%), weakness (47%), seizures (14%).

The mode of presentation varied with tumor type. Patients with leukemia (18%) and lymphoma (13%) tended to present frequently with LM without systemic involvement, or during periods of apparent remission (leukemia 35%, lymphoma 27%), while patients with solid tumors had established systemic metastases (90%) at time of presentation. Laboratory studies did not vary among the groups. 71% had positive cytology on the first lumbar puncture (LP) and only 8% required more than 2 LPs. The cell count was a poor predictor of positive cytology as 29% of LP's with positive cytology and 36% of all LP's had less than 4 cells/mm.

We conclude that 1) LM presents with pain and seizures more frequently than has been previously recognized; 2) LM is frequently the mode of presentation in patients with leukemia and lymphoma and; 3) cytology is positive frequently in CSF specimens with normal cell counts and chemistries.

Key words

leptomeningeal metastasis solid tumors leukemias lymphomas lumbar puncture cytology 

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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • Jerry G. Kaplan
    • 1
  • Trevor G. DeSouza
    • 1
  • Arthur Farkash
    • 1
  • Bronislava Shafran
    • 1
  • Daniel Pack
    • 1
  • Faroog Rehman
    • 1
  • Joachim Fuks
    • 2
  • Russell Portenoy
    • 3
  1. 1.Department of NeurologyAlbert Einstein College of MedicineBronxUSA
  2. 2.The Department of OncologyAlbert Einstein College of MedicineBronx
  3. 3.Memorial Sloan Kettering Cancer Center New YorkNew YorkUSA

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