Cytologically proven meningeal carcinomatosis in patients with lung cancer: clinical observation of 34 cases.
OBJECTIVE
Meningeal carcinomatosis (MC) is a rare neurologic complication of lung cancer. Occasionally, it is the initial presentation of lung cancer. The clinical features of MC exclusively in lung cancer patients have not been well identified and characterized. The purpose of this report is to disclose the clinical features, laboratory findings, treatment and survival of patients with MC from lung cancer.


METHODS
We reviewed the medical records of 34 lung cancer patients with cytologically diagnosed MC at National Taiwan University Hospital from 1992 to 2002. Clinical symptoms and signs, cerebrospinal fluid parameters and lung cancer staging at the time of presentation were summarized. Previous treatment modalities for lung cancer, various treatments and response of MC, complications and survival times were also analyzed.


RESULTS
Cerebrospinal fluid cytology revealed adenocarcinoma in 32 patients, and small cell carcinoma and squamous cell carcinoma in one each. MC occurred in approximately 0.7% of lung cancer patients. Nine patients had MC as the initial presentation of lung cancer. Symptom improvement was found in six patients who had whole brain irradiation for MC and one patient who had a ventriculoperitoneal shunt. Two of the patients with whole brain irradiation survived for longer than 1 year. Survival from cytologic diagnosis of MC ranged from 1 day to 82 weeks (median, 5.1 weeks). There was no difference in survival between patients treated by whole brain irradiation and other treatment modalities.


CONCLUSIONS
The prognosis of MC from lung cancer is poor. A prospective study is needed to establish the effectiveness of combined modality therapy for patients with MC from lung cancer.
Chuang
Tzu-Yi
TY
Department of Internal Medicine, Taoyuan General Hospital, Department of Health, Executive Yuan, Taoyuan, Taiwan.
Yu
Chong-Jen
CJ
Shih
Jin-Yuan
JY
Yang
Pan-Chyr
PC
Kuo
Sow-Hsong
SH
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D055756:Meningeal Carcinomatosis / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate