Neoplastic meningitis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
Neoplastic meningitis has a widely disseminated and progressive presentation. If left untreated, neoplastic meningitis may progress to develop [[seizures]], [[hydrocephalus]], [[encephalopathy]], and ultimately death. Complications of neoplastic meningitis include [[hydrocephalus]], [[encephalopathy]], [[empyema​]], [[cerebritis]], [[cerebral abscess]], and [[stroke]]. The median survival time of patients without treatment of neoplastic meningitis is 4-6 weeks.


==Natural History==
==Natural History==
*Neoplastic meningitis has a widely disseminated and progressive presentation.
*Neoplastic meningitis has a widely disseminated and progressive presentation.
*If left untreated, neoplastic meningitis may progress to develop [[seizures]], [[hydrocephalus]], [[encephalopathy]], and ultimately death. <ref name="dcomplicationsnm1">Complications of leptomeningitis. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningitis. Accessed on January 21, 2016</ref>


==Complications==
==Complications==
Complications of neoplastic meningitis include:<ref name=dcomplicationsnm1>Complications of leptomeningitis. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningitis. Accessed on January 21, 2016</ref>
Complications of neoplastic meningitis include:<ref name="dcomplicationsnm1">Complications of leptomeningitis. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningitis. Accessed on January 21, 2016</ref>
*[[Hydrocephalus]]
*[[Hydrocephalus]]
*[[Encephalopathy]]
*[[Encephalopathy]]
Line 21: Line 23:


==Prognosis==
==Prognosis==
*The median survival time of patients without treatment of neoplastic meningitis is 4-6 weeks.<ref name=prognosisnm123>Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*The median survival time of patients without treatment of neoplastic meningitis is 4-6 weeks.<ref name="prognosisnm123">Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*Neoplastic meningitis due to breast cancer has the best prognosis, where the median survival time is approximately 6 months after diagnosis.<ref name=prognosisnm123>Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*Neoplastic meningitis due to [[breast cancer]] has the best prognosis, where the median survival time is approximately 6 months after diagnosis.<ref name="prognosisnm123">Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*Favorable prognostic factors for neoplastic meningitis include:<ref name=prognosisnmiugkjh>{{cite journal| last= Balm | first= M. | last= Hammack | first=J. | title= Leptomeningeal Carcinomatosis Presenting Features and Prognostic Factors| doi=10.1001/archneur.1996.00550070064013.| Date= 01/22/2016}}</ref>
*Favorable prognostic factors for neoplastic meningitis include:<ref name="prognosisnmiugkjh">{{cite journal| last1= Balm | first1= M. | last2= Hammack | first2=J. | title= Leptomeningeal Carcinomatosis Presenting Features and Prognostic Factors| doi=10.1001/archneur.1996.00550070064013.| Date= 01/22/2016}}</ref>
 
:*Female gender
:*Female gender
:*Longer duration of neurological symptoms
:*Longer duration of neurological symptoms
:*Absence of cerebral leptomeningeal clinical involvement
:*Absence of cerebral [[leptomeningeal]] clinical involvement
:*Absence of elevated CSF protein
:*Absence of elevated [[CSF]] protein
*Poor prognostic factors for neoplastic meningitis include:<ref name=prognosisnm123>Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*Poor prognostic factors for neoplastic meningitis include:<ref name="prognosisnm123">Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
:*Negative hormone receptor status
 
:*Negative [[hormone receptor]] status
:*Poor performance status
:*Poor performance status
:*Multiple fixed neurological deficits
:*Multiple fixed neurological deficits
:*Coexistent carcinomatous encephalopathy
:*Coexistent [[Encephalopathy|carcinomatous encephalopathy]]
:*More than 3 chemotherapy regimes
:*More than 3 [[chemotherapy]] regimes
:*High Cyfra 21-1 level at diagnosis
:*High Cyfra 21-1 level at diagnosis
::*Cyfra 21-1 is a fragment of the cytokeratin-19 and may reflect the tumor burden within the cerebrospinal fluid.
::*Cyfra 21-1 is a fragment of the [[Cytokeratin|cytokeratin-19]] and may reflect the tumor burden within the [[cerebrospinal fluid]].
*Neoplastic meningitis patients treated with intra-CSF chemotherapy have a better prognosis.<ref name=prognosisnmiugkjh>{{cite journal| last= Balm | first= M. | last= Hammack | first=J. | title= Leptomeningeal Carcinomatosis Presenting Features and Prognostic Factors| doi=10.1001/archneur.1996.00550070064013.| Date= 01/22/2016}}</ref>
*Neoplastic meningitis patients treated with intra-[[CSF]] chemotherapy have a better prognosis.<ref name="prognosisnmiugkjh">{{cite journal| last= Hammack | first= J. | title= Leptomeningeal Carcinomatosis Presenting Features and Prognostic Factors| doi=10.1001/archneur.1996.00550070064013.| Date= 01/22/2016}}</ref>


==References==
==References==

Latest revision as of 15:47, 16 August 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Neoplastic meningitis has a widely disseminated and progressive presentation. If left untreated, neoplastic meningitis may progress to develop seizures, hydrocephalus, encephalopathy, and ultimately death. Complications of neoplastic meningitis include hydrocephalus, encephalopathy, empyema​, cerebritis, cerebral abscess, and stroke. The median survival time of patients without treatment of neoplastic meningitis is 4-6 weeks.

Natural History

  • Neoplastic meningitis has a widely disseminated and progressive presentation.
  • If left untreated, neoplastic meningitis may progress to develop seizures, hydrocephalus, encephalopathy, and ultimately death. [1]

Complications

Complications of neoplastic meningitis include:[1]

Prognosis

  • The median survival time of patients without treatment of neoplastic meningitis is 4-6 weeks.[2]
  • Neoplastic meningitis due to breast cancer has the best prognosis, where the median survival time is approximately 6 months after diagnosis.[2]
  • Favorable prognostic factors for neoplastic meningitis include:[3]
  • Female gender
  • Longer duration of neurological symptoms
  • Absence of cerebral leptomeningeal clinical involvement
  • Absence of elevated CSF protein
  • Poor prognostic factors for neoplastic meningitis include:[2]
  • Neoplastic meningitis patients treated with intra-CSF chemotherapy have a better prognosis.[3]

References

  1. ↑ 1.0 1.1 Complications of leptomeningitis. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningitis. Accessed on January 21, 2016
  2. ↑ 2.0 2.1 2.2 Prognosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016
  3. ↑ 3.0 3.1 Balm, M.; Hammack, J. "Leptomeningeal Carcinomatosis Presenting Features and Prognostic Factors". doi:10.1001/archneur.1996.00550070064013. Check |doi= value (help). Unknown parameter |Date= ignored (|date= suggested) (help)


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