title: Leptomeningeal metastasis from solid tumors: a diagnostic and therapeutic challenge.
abstract: Leptomeningeal metastasis (LM) is a severe complication in the natural history of malignancies that occurs in 4-15 % of patients (pts) with solid tumors. Clinical presentation, cerebrospinal fluid cytology (CSF), and gadolinium magnetic resonance imaging (gdMRI) of the brain and spine are the methods routinely used to diagnose LM. Treatment encompasses involved-field radiotherapy of bulky or symptomatic disease sites and chemotherapy; however, no standard therapy has been established yet. We collected and reviewed retrospectively the clinical, pathological, radiological findings as well as the outcomes of 50 consecutive patients with LM from solid tumors to determine whether the diagnostic modalities and therapeutic procedures affected the outcomes. The results of this study confirm the role of gdMRI in the diagnosis of LM in clinical practice and suggest that an aggressive treatment may improve survival in patients with this debilitating and increasingly frequent neurological complication.
authors.affiliation: Division of Neurology, AUSL Cesena, Ospedale Bufalini, Cesena (FC), Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Passarin
authors.forename: Teodoro
authors.initials: T
authors.lastname: Sava
authors.forename: Jenny
authors.initials: J
authors.lastname: Furlanetto
authors.forename: Annamaria
authors.initials: A
authors.lastname: Molino
authors.forename: Rolando
authors.initials: R
authors.lastname: Nortilli
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Musso
authors.forename: Marta
authors.initials: M
authors.lastname: Zaninelli
authors.forename: Tiziano
authors.initials: T
authors.lastname: Franceschi
authors.forename: Daniele
authors.initials: D
authors.lastname: Orrico
authors.forename: Sabrina
authors.initials: S
authors.lastname: Marangoni
authors.forename: Cristina
authors.initials: C
authors.lastname: Dealis
authors.forename: Claudio
authors.initials: C
authors.lastname: Graiff
authors.forename: Rodella
authors.initials: R
authors.lastname: Filippo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grisanti
authors.forename: Edda
authors.initials: E
authors.lastname: Simoncini
authors.forename: Lucia
authors.initials: L
authors.lastname: Vassalli
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
authors.forename: Rebecca
authors.initials: R
authors.lastname: Pedersini
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D008578:Meninges / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium