Skip to main content

Leptomeningeal Metastasis of Primary Central Nervous System (CNS) Neoplasms

  • Chapter

Part of the book series: Cancer Treatment and Research ((CTAR,volume 125))

Abstract

Leptomeningeal dissemination of primary CNS tumors varies widely by histologic subtype. In certain tumors including medulloblastoma, ependymoma, germ cell tumors, and primary CNS lymphoma, seeding of the cerebrospinal fluid space is a critical factor in determining stage, prognosis and appropriate therapy. Other tumor types, such as glioma, may have radiographic evidence of leptomeningeal metastases without clear impact on prognosis or therapy.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ollivier, C.P. De la moelle-epinere et de ses maladies, Ed. 3. Paris, Crevat, 1837.

    Google Scholar 

  2. Bailey P, Cushing H. A classification of the tumors of the glioma group. Philadelphia: J.B. Lippincott Co., 1926.

    Google Scholar 

  3. Burger PG, Scheithauer BW, Vogel FS. Surgical Pathology of the Nervous System and Its Coverings, Fourth Ed. Philadelphia: Churchill Livingstone, pp. 160–578, 2002.

    Google Scholar 

  4. Maksoud YA, Hahn YS, Engelhard HH. Intracranial ependymoma. Neurosurg Focus 2002; 13:1–5.

    Google Scholar 

  5. Natelson SE, Dyer ML, Harp DL. Delayed CSF seeding of benign oligodendroglioma. South Med J 1992; 85:1011–2.

    PubMed  CAS  Google Scholar 

  6. Chamberlain MC. Combined-modality treatment of leptomeningeal gliomatosis. Neurosurg 2003; 52:324–29.

    Article  Google Scholar 

  7. Corsten LA, Raja AI, Wagner FC. Primary diffuse leptomeningeal gliomatosis: a case report. Brit J Neurosurg 2001; 15:62–66.

    Article  CAS  Google Scholar 

  8. Dietrich PY, Aapro MS, Rieder A, Pizzolato GP. Primary diffuse leptomeningeal gliomatosis (PDLG): a neoplastic cause of chronic meningitis. J Neuro-Oncol 1993; 15:275–83.

    Article  CAS  Google Scholar 

  9. Beauchesne P, Pialat J, Duthel R, et al. Aggressive treatment with complete remission in primary diffuse leptomeningeal gliomatosis — a case report. J Neuro-Oncol 1998; 37:161–7.

    Article  CAS  Google Scholar 

  10. Havlik DM, Becher MW, Nolte KB. Sudden death due to primary diffuse leptomeningeal gliomatosis. J Forensic Sci 2001; 46:392–5.

    PubMed  CAS  Google Scholar 

  11. Lachance DH, O'Neill BP, Macdonald DR, et al. Primary leptomeningeal lymphoma: report of 9 cases, diagnosis with immunohistochemical analysis, and review of the literature. Neurology 1991; 41:95–100.

    PubMed  CAS  Google Scholar 

  12. Balhuizen JC, Bots GTAM, Schaberg A, Bosman FT. Value of cerebrospinal fluid cytology for the diagnosis of malignancies in the central nervous system. J Neurosurg 1978;48:747–753.

    PubMed  CAS  Google Scholar 

  13. Johnson DL, Schwarz S. Intracranial metastases from malignant spinal-cord astrocytoma. Case report. J Neurosurg 1987; 66:621–5.

    PubMed  CAS  Google Scholar 

  14. Obana WG, Cogen PH, Davis RL, Edwards MS. Metastatic juvenile pilocytic astrocytoma. J Neurosurg 1991; 75:972–975.

    PubMed  CAS  Google Scholar 

  15. Packer RJ, Siegel KR, Sutton LN, et al. Leptomeningeal dissemination of primary central nervous system tumors of childhood. Annals Neurol 1985; 18:217–221.

    Article  CAS  Google Scholar 

  16. Nishio S, Korosue K, Tateishi J, Fukui M, Kitamura K. Ventricular and subarachnoid seeding of intracranial tumors of neuroectodermal origin — a study of 26 consecutive autopsy cases with reference to focal ependymal defect. Clin Neuropathol 1982; 1:83–91.

    PubMed  CAS  Google Scholar 

  17. Elliott JP, Keles GE, Waite M, Temkin N, Berger MS. Ventricular entry during resection of malignant gliomas: effect on intracranial cerebrospinal fluid tumor dissemination. J Neurosurg 1994; 80:834–9.

    PubMed  CAS  Google Scholar 

  18. Bolteus AJ, Berens ME, Pilkington GJ. Migration and invasion in brain neoplasms. Curr Neurol Neurosci Rep 2002; 1:225–32.

    Google Scholar 

  19. Chicoine MR, Silbergeld DL. Mitogens as motogens. J Neuro-Oncol 1997; 35:249–57.

    Article  CAS  Google Scholar 

  20. Cinalli G, Sainte-Rose C, Lellouch-Tubiana A, et al. Hydrocephalus associated with intramedullary low-grade glioma. Illustrative cases and review of the literature. J Neurosurg 1995; 83:480–5.

    PubMed  CAS  Google Scholar 

  21. Giese A, Bjerkvig R, Berens ME, Westphal M. Cost of migration: invasion of malignant gliomas and implications for treatment. J Clin Oncol 2003; 21:1624–36.

    Article  PubMed  CAS  Google Scholar 

  22. Binder DK, Berger MS. Proteases and the biology of glioma invasion. J Neuro-Oncol 2002; 56:149–58.

    Article  Google Scholar 

  23. Engelhard HH, Narang C, Homer R, Duncan H. (1996) Urokinase antisense oligodeoxynucleotides as a novel agent for malignant glioma: In vitro and in vivo studies of uptake, effects and toxicity. Biochem Biophys Res Commun 1996; 227:400–405.

    Article  PubMed  CAS  Google Scholar 

  24. Levicar N, Nuttall RK, Lah TT, Nuttall RK. Proteases in brain tumor progression. Acta Neurochi 2003; 145:825–38.

    Article  CAS  Google Scholar 

  25. Rooprai HK, McCormick D. Proteases and there inhibitors in human brain tumors: a review. Anticancer Res 1997; 17:4151–62.

    PubMed  CAS  Google Scholar 

  26. Yamamoto M, Ueno Y, Hayashi S, Fukushima T. The role of proteolysis in tumor invasiveness in glioblastoma and metastatic brain tumors. Anticancer Res 2002; 22:4265–8.

    PubMed  CAS  Google Scholar 

  27. Asano K, Kubo O, Tajika Y. et al. Expression of cadherin and CSF dissemination in malignant astrocytic tumors. Neurosurg Rev 2000; 23, 39–44.

    Article  PubMed  CAS  Google Scholar 

  28. Baltuch GH, Tribolet N, Van Meir EG. Expression of the CD44 adhesion molecule in tumours of the central and peripheral nervous system. J Neuro-Oncol 1995; 26:191–198.

    Article  CAS  Google Scholar 

  29. Eibl RH, Pietsch T, Moll J, Skroch-Angle P. et al. Expression of varient CD44 epitopes in human astrocytic brain tumors. J Neuro-Oncol 1995; 26:165–170.

    Article  CAS  Google Scholar 

  30. Kaaijk P, Troost D, Morsink F, Keehnen RMJ, et al. Expression of CD44 splice variants in human primary brain tumors. J Neuro-Oncol 1995; 26:185–190.

    Article  CAS  Google Scholar 

  31. Allen JC, Epstein F. Medulloblastoma and other primary malignant neuroectodermal tumors of the CNS. J Neurosurg 1982; 57: 446–451.

    PubMed  CAS  Google Scholar 

  32. Jennings MT, Slatkin N, D'Angelo M, et al. Neoplastic meningitis as the presentation of occult primitive neuroectodermal tumors. J Child Neurol 1993; 8:306–12.

    Article  PubMed  CAS  Google Scholar 

  33. Kellie SJ, Kovnar EH, Kun LE, et al. Neuraxis dissemination in pediatric brain tumors. Cancer l992; 69:1061–1066.

    Google Scholar 

  34. Schild SE, Nisi K, Scheithauer BW, Wong WW, Lyons MK, Schomberg PJ, Shaw EG. The results of radiotherapy for ependymomas: the Mayo Clinic experience. Intl J Radiation Oncology, Biology, Physics 1998; 42:953–8.

    Article  CAS  Google Scholar 

  35. Flannery AM, Tomita T, Radkowski M, McLone DG. Medulloblastomas in childhood: postsurgical evaluation with myelography and cerebrospinal fluid cytology. J Neuro-Oncol 1990; 8: 149–51.

    Article  CAS  Google Scholar 

  36. Park TS, Hoffman HJ, Hendrick EB, et al. Medulloblastoma: clinical presentation and management. J Neurosurg 1983; 58:543–552.

    PubMed  CAS  Google Scholar 

  37. Shapiro K, Shulman, K. Spinal cord seeding from cerebellar astrocytoma. Child's Brain 1996; 2:177–186.

    Google Scholar 

  38. Tomita T, McLone DG. Spontaneous seeding of medulloblastoma: results of cerebrospinal fluid cytology and arachnoid biopsy from the cisterna magna. Neurosurg 1983;12:265–7.

    CAS  Google Scholar 

  39. Akar Z, Tanriover N, Kafadar AM, Gazioglu N, Oz B, Kuday C. Chiasmatic low-grade glioma presenting with sacral intradural spinal metastasis. Childs Nerv Syst 2000; 16:309–11.

    Article  PubMed  CAS  Google Scholar 

  40. Auer RN, Rice GPA, Hinton GG, Amacher AL, Gilbert JJ Cerebellar astrocytoma with benign histology and malignant clinical course. J Neurosurg 1981; 54:128–132.

    PubMed  CAS  Google Scholar 

  41. Civitello LA, Packer RJ, Rorke LB, Siegel K, Sutton LN, Schut L. Leptomeningeal dissemination of low-grade gliomas in children. Neurol 1988; 38:562–566.

    CAS  Google Scholar 

  42. Kandt RS, Shinnar S, D'Souza BJ, Singer HS, et al. Cerebrospinal metastases in malignant childhood astrocytomas. J Neuro-Oncol 1984; 2:123–128.

    Article  CAS  Google Scholar 

  43. Leonard N, Alcutt DA, Farrell MA. Fatal pleomorphic xanthoastrocytoma with meningeal gliomatosis. Histopathol 1998; 32: 375–8.

    Article  CAS  Google Scholar 

  44. Littmen P, Jarrett P, Bilaniuk LT, et al. Pediatric brain stem gliomas. Cancer 1980;45:2787–2792.

    Google Scholar 

  45. Mishima K, Nakamura M, Nakamura H, et al. Leptomeningeal dissemination of cerebellar pilocytic astrocytoma. J Neurosurg 1992; 77:788–791.

    PubMed  CAS  Google Scholar 

  46. Morikawa M, Tamaki N, Kokunai T, et al. Cerebellar pilocytic astrocytoma with leptomeningeal dissemination: case report. Surg Neurol 1997; 48:49–52.

    Article  PubMed  CAS  Google Scholar 

  47. Packer RJ, Allen J, Nielsen S, et al. Brainstem glioma: clinical manifestations of meningeal gliomatosis. Annals Neurol 1983; 14:177–182.

    Article  CAS  Google Scholar 

  48. Pollack IF, Hurtt M, Pang D, Albright AL. Dissemination of low grade intracranial astrocytomas in children. Cancer l994; 73:2869–78.

    Google Scholar 

  49. Versari P, Talamonti G, D'Alibeti G, et al. Leptomeningeal dissemination of juvenile pilocytic astrocytoma: case report. Surg Neurol 1994; 41:318–321.

    Article  PubMed  CAS  Google Scholar 

  50. Aoyama I, Makita, Y, Nabeshima S, Moomochi M, Masuda A. Extradural nasal and orbital extension of glioblastoma multiforme without previous surgical intervention. Surg Neurol 1980; 14:343–7.

    PubMed  CAS  Google Scholar 

  51. Awad I, Bay JW, Rogers L. Leptomeningeal metastasis from supratentorial malignant gliomas. Neurosurgery 1986; 19:247–251.

    Article  PubMed  CAS  Google Scholar 

  52. Coakham HB, Richardson RB, Davies AG, Bourne SP, Eckert H, Kemshead JT. Neoplastic meningitis from a pineal tumor treated by antibody-guided irradiation via the intrathecal route. British J Neurosurg 1988; 2:199–209.

    CAS  Google Scholar 

  53. Eng DY, DeMonte F, Ginsberg L, Fuller GN, Jaeckle K. Craniospinal dissemination of central neurocytoma. Report of two cases. J Neurosurg 1997; 86:547–52.

    PubMed  CAS  Google Scholar 

  54. Gajjar A, Bhargava R, Jenkins JJ. Low-grade astrocytoma with neuraxis dissemination at diagnosis. J Neurosurg 1995; 83:67–71.

    Article  PubMed  CAS  Google Scholar 

  55. Gaspar LE, Mackenzie IR, Gilbert JJ, et al. Primary cerebral fibrosarcomas. Clinicopathologic study and review of the literature. Cancer 1993; 72:3277–81.

    PubMed  CAS  Google Scholar 

  56. Giordana MT, Cavalla P, Allegranza A, Polio B. Intracranial dissemination of pituitary adenoma. Case report and review of the literature. Italian J Neurolog Sci 1994; 15:195–200.

    Article  CAS  Google Scholar 

  57. Grossman SA, Celano P. Neoplastic meningitis. N Engl J Med 2001; 344:494.

    Article  PubMed  CAS  Google Scholar 

  58. Ito M, Jamshidi J, Yamanaka K. Does craniopharyngioma metastasize? Case report and review of the literature. Neurosurg 2001; 48:933–5.

    Article  CAS  Google Scholar 

  59. Kamiya K, Inagawa T, Nagasako R. Malignant intraventricular meningioma with spinal metastasis through the cerebrospinal fluid. Surg Neurol 1989; 32:213–8.

    Article  PubMed  CAS  Google Scholar 

  60. Kawano N, Yada K, Ogawa Y, Sasaki K. Spontaneous transdural extension of malignant astrocytoma. J Neurosurg 1977; 47:766–770.

    PubMed  CAS  Google Scholar 

  61. Kim JH, Jung HW, Kim YS, et al. Meningeal hemangiopericytomas: long term outcome and biological behavior. Surg Neurol 2003; 59:47–53.

    Article  PubMed  Google Scholar 

  62. Ley A, Campillo D, Oliveras C. Extracranial metastasis of glioblastoma multiforme. J Neurosurg 1961; 18:313–330.

    PubMed  CAS  Google Scholar 

  63. Mantravadi RVP, Phatak R, Bellur S, et al. Brainstem gliomas: an autopsy study of 25 cases. Cancer l982; 49:1294–1296.

    Google Scholar 

  64. Moore MT, Eisinger G. Extra primary seeding of glioblastoma multiforme in the subarachnoid space and ependyma. Neurol 1963; 13: 855–865.

    CAS  Google Scholar 

  65. Ng HK, Tang NL, Poon WS. Polar spongioblastoma with cerebrospinal fluid metastases. Surg Neurol 1994; 41:137–42.

    Article  PubMed  CAS  Google Scholar 

  66. Silverberg GD, Hanbery JW. Meningeal invasion by gliomas. J Neurosurg 1971; 34:549–554.

    PubMed  CAS  Google Scholar 

  67. Tognetti F, Piazza G, Morrone B. High grade astrocytoma with spontaneous meningeal and cranial invasion. Neurosurg 1982; 11:813–815.

    CAS  Google Scholar 

  68. Wai-kwan AY, Horten BC, Shapiro WR. Meningeal gliomatosis: a review of 12 cases. Ann Neurol 1980; 8:605–608.

    Article  Google Scholar 

  69. Yamaki T, Otaki M, Uede T, et al. Extensive spinal necrosis with spinal leptomeningeal dissemination of cerebral astrocytoma: case report. Acta Neurochir 1988; 93:146–148.

    Article  CAS  Google Scholar 

  70. Bell WO, Packer RJ, Seigel KR, Borke, LB, Sutton, LN, Bruce, D.A., Schut, L. Leptomeningeal spread of intramedullary spinal cord tumors. J Neurosurg 1988; 69:295–300.

    PubMed  CAS  Google Scholar 

  71. Hely M, Fryer J, Selby G. Intramedullary spinal cord glioma with intracranial seeding. J Neurol Neurosurg Psych 1985; 48:302–9.

    Article  CAS  Google Scholar 

  72. Ng HK, Leung CH, Boet R, Poon WS. Spinal cord pilocytic astrocytoma with cranial meningeal metastases. J Clin Neuroscience 2001; 8:374–7.

    Article  CAS  Google Scholar 

  73. Erlich SS, Davis RL. Spinal subarachnoid metastases from primary intracranial glioblastoma multiforme. Cancer 1978; 42:2854–64.

    PubMed  CAS  Google Scholar 

  74. Onda K, Tanaka R, Takahashi H, Takeda N, Ikuta F. Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurg 1989; 25:533–40.

    Article  CAS  Google Scholar 

  75. Engelhard HH, Porter KR, Stewart AK, Olson JJ. Overview of the results of the Commission on Cancer's Central Nervous System (CNS) Tumor Patient Care Evaluation Study. Proc Am Assoc Cancer Res 2004; 45:164.

    Google Scholar 

  76. Murakami M, Kuratsu J, Takeshima H, et al. Spinal seeding of anaplastic ependymoma mimicking fungal meningitis. A case report and review of the literature. J Neurosurg Sci 2000;44:46–51.

    PubMed  CAS  Google Scholar 

  77. Trivedi RA, Nichols P, Coley S, et al. Leptomeningeal glioblastoma presenting with multiple cranial neuropathies and confusion. Clin Neurol Neurosurg 2000; 102:223–6.

    Article  PubMed  CAS  Google Scholar 

  78. Fujimura M, Kumabe T, Jokura H, Shirane R, Yoshimoto T, Tominaga T. Intractable vomiting as an early clinical symptom of cerebrospinal fluid seeding to the fourth ventricle in patients with high-grade astrocytoma. J Neuro-Oncol 2004; 66:209–16.

    Article  Google Scholar 

  79. Tamura, Zama A, Kurihara H, et al. Management of recurrent pilocytic astrocytoma with leptomeningeal dissemination in childhood. Childs Nerv Syst 1998; 14:617–22.

    Article  PubMed  CAS  Google Scholar 

  80. Packer RJ, Sutton LN, Rorke LB, et al. Prognostic importance of cellular differentiation in medulloblastoma of childhood. J Neurosurg 1984; 61:296–301.

    Article  PubMed  CAS  Google Scholar 

  81. Black PM, Callahan LV, Kornblith PL. Tissue cultures from cerebrospinal fluid specimens in the study of human brain tumors. J Neurosurg 1978; 49:697–704.

    PubMed  CAS  Google Scholar 

  82. Witham TF, Fukui MB, Meltzer CC, et al. Survival of patients with high grade glioma treated with intrathecal thiotriethylenephosphoramide for ependymal or leptomeningeal gliomatosis. Cancer 1999; 86:1347–53.

    Article  PubMed  CAS  Google Scholar 

  83. Engelhard HH, Misra M, Rosen FR. Interstitial chemotherapy for the treatment of malignant glioma. Adv Clin Neurosci 2000; 10:341–53.

    Google Scholar 

  84. Engelhard HH, Petruska DA. Movement and imaging of iron oxide-bound antibodies in brain and cerebrospinal fluid. Cancer Biochem Biophys 1992; 13:224–36.

    Google Scholar 

  85. Coakham HB, Kemshead JT. Treatment of neoplastic meningitis by targeted radiation using (131)I-radiolabelled monoclonal antibodies. Results of responses and long term follow-up in 40 patients. J Neuro-Oncol 1998; 38:225–32.

    Article  CAS  Google Scholar 

  86. Nakagawa H, Fujita T, Kubo S, et al. Ventriculolumbar perfusion chemotherapy with methotrexate and cytosine arabinoside for meningeal carcinomatosis: a pilot study in 13 patients. Surg Neurol 1996; 45:256–64.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer Science+Business Media, Inc.

About this chapter

Cite this chapter

Engelhard, H.H., Corsten, L.A. (2005). Leptomeningeal Metastasis of Primary Central Nervous System (CNS) Neoplasms. In: Abrey, L.E., Chamberlain, M.C., Engelhard, H.H. (eds) Leptomeningeal Metastases. Cancer Treatment and Research, vol 125. Springer, Boston, MA. https://doi.org/10.1007/0-387-24199-X_5

Download citation

  • DOI: https://doi.org/10.1007/0-387-24199-X_5

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-24198-2

  • Online ISBN: 978-0-387-24199-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics