Can you survive leptomeningeal disease?
Despite advances in targeted radiation and chemotherapy, survival remains poor after diagnosis of leptomeningeal involvement, averaging 3–6 months. Survival varies by etiology, with breast cancer patients having the best prognosis (13–25% survival at one year and 6% at two years) [1, 4, 5].
What is the prognosis for leptomeningeal disease?
This disease has a very low survival rate. With treatment, survival is about 3 to 6 months. Without treatment, survival is 4 to 6 weeks. The most common treatment for leptomeningeal disease is radiation therapy.
What are the symptoms of leptomeningeal disease?
Symptoms of Leptomeningeal Metastases
- Headaches.
- Nausea (feeling like you’re going to throw up) or vomiting (throwing up)
- Difficulty thinking.
- Double vision.
- Dizziness.
- Difficulty speaking or swallowing.
- Pain in your arms and legs.
- Weakness or lack of coordination in your arms and legs.
How fast does leptomeningeal disease progress?
Reported outcomes of LM from solid tumors have indicated high rates of progression to death within 4 to 6 weeks without therapy [7].
Why is leptomeningeal disease fatal?
Since leptomeningeal disease cancer cells float in the cerebrospinal fluid, they can quickly spread throughout the central nervous system. As a result, leptomeningeal disease has a poor prognosis, with survival typically measured in months.
Is leptomeningeal disease rare?
Leptomeningeal disease is an uncommon condition that occurs in about 5% of cancer patients.
How is leptomeningeal diagnosed?
Magnetic resonance imaging (MRI) of the brain and spine, with and without contrast, is the gold standard in diagnosing leptomeningeal disease. Sometimes the disease occurs only in the spine and not the brain, and therefore a scan of the full spine and brain is recommended.
Can leptomeningeal disease be misdiagnosed?
We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare.
What does leptomeningeal look like on MRI?
On MRI, leptomeningeal enhancement is characterized by high signal intensity within the subarachnoid space of the sulci and cisterns on post-contrast T1 weighted images.
Can leptomeningeal be benign?
Although rare, local recurrence or leptomeningeal spread of meningeal melanocytoma secondary to malignant transformation has been reported years after the initial diagnosis (2-4). In a literature review, there was only one case report of a meningeal melanocytoma causing a diffuse benign leptomeningeal spread.
How is leptomeningeal disease treated?
A combination of surgery, radiation, and chemotherapy treatment improves the prognosis for leptomeningeal disease. Some tumor types are especially sensitive to chemotherapy injected directly into the cerebrospinal fluid, either by lumbar puncture (“spinal tap”) or through a surgically implanted device called an Ommaya.
Can leptomeningeal be misdiagnosed?
How to manage hydrocephalus in patients with leptomeningeal metastases?
Management of hydrocephalus in patients with leptomeningeal metastases: an ethical approach to decision-making The decision of how to manage LM-associated hydrocephalus is complex and requires close collaboration amongst the physician, patient, and/or patient’s family/friends/community leaders.
What is leptomeningeal disease (LMD)?
INTRODUCTION Leptomeningeal disease (LMD) is a late-stage complication of systemic cancers caused by multifocal metastases to the leptomeninges, which consist of the pia mater, arachnoid, and subarachnoid space.
Is leptomeningeal disease a primary source of cancer?
Leptomeningeal disease has become increasingly prevalent as novel therapeutic interventions extend the survival of cancer patients. Although a majority of leptomeningeal spread occurs secondary to breast cancer, lung cancer, and melanoma, a wide variety of malignancies have been reported as primary sources.
What are leptomeningeal metastases (LM)?
Purpose: Leptomeningeal metastases (LM) are a rare, but often debilitating complication of advanced cancer that can severely impact a patient’s quality-of-life. LM can result in hydrocephalus (HC) and lead to a range of neurologic sequelae, including weakness, headaches, and altered mental status.