Georgios Rigakos1, Chrysoula I Liakou1, Naillid Felipe2, Dennis Orkoulas-Razis3, Evangelia Razis4. 1. Third Oncology Department, Hygeia Hospital, Marousi, Athens, Greece. 2. Boston University School of Medicine, Boston, MA. 3. University of Maryland School of Medicine, Baltimore, MD. 4. Third Oncology Department, Hygeia Hospital, Marousi, Athens, Greece. Erazis@hygeia.gr.
Abstract
BACKGROUND: Neoplastic meningitis is a complication of solid and hematological malignancies. It consists of the spread of malignant cells to the leptomeninges and subarachnoid space and their dissemination within the cerebrospinal fluid. METHODS: A literature review was conducted to summarize the clinical presentation, differential diagnosis, laboratory values, and imaging findings of neoplastic meningitis. RESULTS: Neoplastic meningitis is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis. In general, characteristic findings on gadolinium-enhanced magnetic resonance imaging and the presence of malignant cells in the cerebrospinal fluid remain the cornerstones of diagnosis. However, both modalities do not always confirm the diagnosis of neoplastic meningitis despite a typical clinical picture. CONCLUSIONS: Clinicians treating patients with cancer should be aware of the possibility of neoplastic meningitis, especially when multilevel neurological symptoms are present. Neoplastic meningitis can be an elusive diagnosis, so clinician awareness is important so that this malignant manifestation is recognized in a timely manner.
BACKGROUND:Neoplastic meningitis is a complication of solid and hematological malignancies. It consists of the spread of malignant cells to the leptomeninges and subarachnoid space and their dissemination within the cerebrospinal fluid. METHODS: A literature review was conducted to summarize the clinical presentation, differential diagnosis, laboratory values, and imaging findings of neoplastic meningitis. RESULTS:Neoplastic meningitis is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis. In general, characteristic findings on gadolinium-enhanced magnetic resonance imaging and the presence of malignant cells in the cerebrospinal fluid remain the cornerstones of diagnosis. However, both modalities do not always confirm the diagnosis of neoplastic meningitis despite a typical clinical picture. CONCLUSIONS: Clinicians treating patients with cancer should be aware of the possibility of neoplastic meningitis, especially when multilevel neurological symptoms are present. Neoplastic meningitis can be an elusive diagnosis, so clinician awareness is important so that this malignant manifestation is recognized in a timely manner.
Authors: Bruno De Potter; Jef Huyskens; Birgitta Hiddinga; Maarten Spinhoven; Annelies Janssens; Jan P van Meerbeeck; Paul M Parizel; Annemie Snoeckx Journal: Insights Imaging Date: 2018-04-11