title: Cranial and spinal leptomeningeal dissemination in esthesioneuroblastoma: Two reports of distant central nervous system metastasis and rationale for treatment.
abstract: BACKGROUND
  Esthesioneuroblastoma is a locally aggressive cancer of the nasal cavity. While systemic metastasis can occur in 10-30% of patients, there are only six reported cases of distal metastasis from leptomeningeal dissemination.
  
  
  METHODS
  The authors report two cases of esthesioneuroblastoma treated previously with multimodal therapy in which distal metastatic recurrence was found and describe their treatment protocol, which has resulted in long-term success.
  
  
  CONCLUSIONS
  Understanding the drivers of leptomeningeal dissemination in more prevalent primary neuroectodermal tumors may hold the key to developing successful treatment algorithms for this disease.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Walavan
authors.initials: W
authors.lastname: Sivakumar
authors.affiliation: Department of Neurosurgery, Loma Linda University, Loma Linda, California 92354, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Cutler
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Colman
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: William T
authors.initials: WT
authors.lastname: Couldwell
keywords: Carcinomatosis; chemotherapy; esthesioneuroblastoma; leptomeningeal dissemination; olfactory neuroblastoma; primary neuroectodermal tumor; radiation; surgery