title: Leptomeningeal carcinomatosis in esophageal cancer: a case series and systematic review of the literature.
abstract: The aim of this study was to more clearly define the clinical course of leptomeningeal carcinomatosis due to esophageal cancer. A single institution retrospective case series was conducted. Additionally, a systematic review of the literature was performed. We present a large case series (n = 7) of leptomeningeal carcinomatosis due to esophageal cancer. Our case series and systematic review of the literature report similar findings. In our series, we report a predominance of male patients (86%) with adenocarcinoma histology (77%). Variable onset of leptomeningeal involvement of esophageal cancer in relation to the original diagnosis of the primary disease (5 months to 3 years and 11 weeks) was noted. Disease progresses quickly and overall survival is poor, measured in weeks (2.5-16 weeks) from the diagnosis of leptomeningeal involvement. Four of our patients initiated whole-brain radiation therapy with only two completing the course prior to clinical deterioration. Our patient with the longest survival (16 weeks) received intrathecal topotecan and oral temozolomide. Leptomeningeal carcinomatosis secondary to esophageal cancer has a poor prognosis. A clearly beneficial treatment modality is lacking.
authors.affiliation: Department of Neurology, University of Chicago, Chicago, Illinois, USA.
authors.forename: R V
authors.initials: RV
authors.lastname: Lukas
authors.affiliation: Department of Pediatric Neurology, Loyola University, Chicago, Illinois, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Mata-Machado
authors.affiliation: Department of Neurology, University of Chicago, Chicago, Illinois, USA.|Department of Surgery-Section of Neurosurgery, University of Chicago, Chicago, Illinois, USA.|Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Nicholas
authors.affiliation: Department of Medicine-Section of Hematology & Oncology, University of Chicago, Chicago, Illinois, USA.
authors.forename: R
authors.initials: R
authors.lastname: Salgia
authors.affiliation: Department of Pathology, University of Chicago, Chicago, Illinois, USA.
authors.forename: T
authors.initials: T
authors.lastname: Antic
authors.affiliation: Department of Medicine-Section of Hematology & Oncology, University of Chicago, Chicago, Illinois, USA.
authors.forename: V M
authors.initials: VM
authors.lastname: Villaflor
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D055756:Meningeal Carcinomatosis / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
keywords: carcinomatous meningitis; cerebrospinal fluid; esophageal neoplasms; leptomeningeal carcinomatosis; meningeal carcinomatosis