Aggressive treatment with complete remission in primary diffuse leptomeningeal gliomatosis--a case report.
Primary leptomeningeal gliomatosis is rare, and the diffuse form (PLDG) is even more unusual. The following report is an example. A 17 year-old man developed a syndrome characterized by extensive basal and chronic spinal meningitis. Routine biological tests showed elevated levels of CSF proteins, and moderate mononuclear pleocytosis, with no direct evidence of neoplasia, leading to a diagnosis of chronic meningitis. A second meningeal biopsy, guided by MRI and performed in the left frontal region, led to the specific diagnosis of primary diffuse leptomeningeal gliomatosis. Treatment including ventricular and lumbar shunting, a course of cortico-spinal radiation, and three courses of an eight-drug systemic chemotherapy with intrathecal methotrexate lead to complete remission over 15 months. We believe that this is the first report of such a remission in the literature.
Beauchesne
P
P
Service de Neurochirurgie, Centre Hospitalier Universitaire, Saint-Etienne, France.
Pialat
J
J
Duthel
R
R
Barral
F G
FG
Clavreul
G
G
Schmitt
T
T
Laurent
B
B
D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D002557:Cerebrospinal Fluid Shunts; D003131:Combined Modality Therapy; D005910:Glioma / Q000175:diagnosis / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000628:therapy*; D008727:Methotrexate / Q000627:therapeutic use; D012074:Remission Induction
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate