Journal of Neuro-Oncology

, Volume 101, Issue 3, pp 509–511 | Cite as

Prolonged survival of neoplastic meningitis from breast cancer with letrozole and intrathecal methotrexate: a case report

  • Stavros PeroukidesEmail author
  • Adimchi Onyenadum
  • Ioannis Starakis
  • Angelos Koutras
  • Thomas Makatsoris
  • George Bouboukas
  • Haralabos Kalofonos
Case Report


Neoplastic meningitis from breast cancer has a dismal prognosis and short survival. Treatment is based on the intrathecal administration of chemotherapeutic agents, cranial or craniospinal radiotherapy, and systemic chemotherapy. In this report we describe the case of a woman with neoplastic meningitis from breast carcinoma who developed an excellent response to letrozole combined with intrathecal methotrexate, resulting in long-term survival of more than 36 months. Based on the findings of this case report, we suggest that addition of letrozole to the standard therapeutic approach may be beneficial for some patients.


Neoplastic meningitis Breast carcinoma Letrozole Methotrexate Cerebrospinal fluid 


  1. 1.
    Moots P, Harrison M, Vandenberg S (1995) Prolonged survival in carcinomatous meningitis associated with breast cancer. South Med J 88:357–362PubMedGoogle Scholar
  2. 2.
    Boogerd W, Bent MJ, Koehler PJ et al (2004) The relevance of intraventricular chemotherapy for leptomeningeal metastasis in breast cancer: a randomized study. Eur J Cancer 40:2726–2733CrossRefPubMedGoogle Scholar
  3. 3.
    Chamberlain M (2005) Neoplastic meningitis. J Clin Oncol 23:3605–3613CrossRefPubMedGoogle Scholar
  4. 4.
    Chamberlain M (2008) Neoplastic meningitis. The Oncologist 13:967–977CrossRefPubMedGoogle Scholar
  5. 5.
    Boogerd W, Dorresteijn LD, van Der Sande JJ, de Gast GC, Bruning PF (2000) Response of leptomeningeal metastases from breast cancer to hormonal therapy. Neurology 12:117–119Google Scholar
  6. 6.
    Ozdogan M, Samur M, Bozcuk H et al (2003) Durable remission of leptomeningeal metastasis of breast cancer with letrozole: a case report and implications of biomarkers on treatment selection. Jpn J Clin Oncol 33:229–231CrossRefPubMedGoogle Scholar
  7. 7.
    Jayson G, Howell A (1996) Carcinomatous meningitis in solid tumors. Ann Oncol 7:773–786PubMedGoogle Scholar
  8. 8.
    Garcia-Casado Z, Guerrero-Zotano A, Llombart-Cussac A et al (2010) A polymorphism at the 3′-UTR region of the aromatase gene defines a subgroup of postmenopausal breast cancer patients with poor response to neoadjuvant letrozole. BMC Cancer 10:36CrossRefPubMedGoogle Scholar
  9. 9.
    Neville-Webbe HL, Coleman RE, Holen I (2010) Combined effects of the bisphosphonate, zoledronic acid and the aromatase inhibitor letrozole on breast cancer cells in vitro: evidence of synergistic interaction. Br J Cancer 102:1010–1017CrossRefPubMedGoogle Scholar
  10. 10.
    Lien EA, Wester K, Lonning PE, Solheim E, Ueland PM (1991) Distribution of tamoxifen and metabolites into brain tissue and brain metastases in breast cancer patients. Br J Cancer 63:641–645CrossRefPubMedGoogle Scholar
  11. 11.
    Madhup R, Kirti S, Bhatt MLB et al (2006) Letrozole for brain and scalp metastases from breast cancer—a case report. The Breast 15:440–442CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Stavros Peroukides
    • 1
    Email author
  • Adimchi Onyenadum
    • 1
  • Ioannis Starakis
    • 2
  • Angelos Koutras
    • 1
  • Thomas Makatsoris
    • 1
  • George Bouboukas
    • 1
  • Haralabos Kalofonos
    • 1
  1. 1.Department of Medical Oncology, School of MedicineUniversity of PatrasPatrasGreece
  2. 2.Department of Internal Medicine, School of MedicineUniversity of PatrasPatrasGreece

Personalised recommendations