Neoplastic meningitis overview: Difference between revisions
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==Differentiating Neoplastic Meningitis from other Diseases== | ==Differentiating Neoplastic Meningitis from other Diseases== | ||
Neoplastic meningitis must be differentiated from infections ([[meningitis]], [[Lyme disease]], [[neurocysticercosis]]), neoplastic ([[intracerebral metastasis]], dural metastasis), inflammatory ([[rheumatoid arthritis]], [[multiple sclerosis]], [[polychondritis]]), and granulomatous disorders ([[sarcoidosis]], [[histiocytosis]], [[Wegener's granulomatosis]], [[vasculitis]]).<ref name=ddxmeningitis>Leptomeningitis. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningitis. Accessed on January 21, 2016</ref> | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Neoplastic meningitis occurs in approximately 3-5% of patients with solid tumor, 5-15% of patients with leukemia, and 1-2% of patients with primary brain tumors.<ref name="GleissnerChamberlain2006">{{cite journal|last1=Gleissner|first1=Beate|last2=Chamberlain|first2=Marc Charles|title=Neoplastic meningitis|journal=The Lancet Neurology|volume=5|issue=5|year=2006|pages=443–452|issn=14744422|doi=10.1016/S1474-4422(06)70443-4}}</ref><ref name=epidemiologynm2>Hayat, M. A. Brain metastases from primary tumors : epidemiology, biology, and therapy. London: Elsevier/Academic Press, 2014. Print.| url=https://books.google.com/books?id=IloXAwAAQBAJ&pg=PA43&lpg=PA43&dq=leptomeningeal+carcinomatosis+is+present+in+1-5%25+of+patients+with+solid+tumors,+5-15%25+of+patients+with+leukemia,+and+1-2%25+of+patients+with+primary+brain+tumors.&source=bl&ots=ehEaDBCT5f&sig=vvSxdxDjNMBe0CdCP6fEcMaYJqU&hl=en&sa=X&ved=0ahUKEwi2ueuw37bKAhUG8j4KHWUUCoIQ6AEILTAC#v=onepage&q=leptomeningeal%20carcinomatosis%20is%20present%20in%201-5%25%20of%20patients%20with%20solid%20tumors%2C%205-15%25%20of%20patients%20with%20leukemia%2C%20and%201-2%25%20of%20patients%20with%20primary%20brain%20tumors.&f=false. Accessed on January 19, 2016</ref> | |||
==Risk Factors== | ==Risk Factors== | ||
There are no established risk factors for neoplastic meningitis. | |||
==Screening== | ==Screening== | ||
There is insufficient evidence to recommend routine screening for neoplastic meningitis.<ref name=screen>Early detection, diagnosis, and staging of brain tumors. American cancer society. http://www.cancer.org/cancer/braincnstumorsinadults/detailedguide/brain-and-spinal-cord-tumors-in-adults-detection</ref> | |||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== |
Revision as of 14:35, 25 January 2016
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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 is the development of meningitis due to infiltration of the subarachnoid space by tumor cells. Malignant cells come from primary cancer such as breast cancer or from a primary brain tumor like medulloblastoma.[1] The microscopic pathology of neoplastic meningitis may vary according to the primary cancer involved. Generally, on microscopic histopathological analysis, neoplastic meningitis is characterized by large, hyperchromatic cells.
Historical Perspective
Neoplastic meningitis was first reported in the 1870's.[1]
Classification
There is no classification system established for neoplastic meningitis.
Pathophysiology
Neoplastic meningitis refers to the spread of malignant cells through the cerebrospinal fluid space. These cells can be originated both in primary CNS tumors (e.g. drop-metastases), as well as from distant tumors that have metastasized (hematogenous spread).[2] The microscopic pathology of neoplastic meningitis may vary according to the primary cancer involved. Generally, on microscopic histopathological analysis, neoplastic meningitis is characterized by large, hyperchromatic cells.[3]
Causes
Common causes of neoplastic meningitis include primary intracerebral malignancies (glioblastoma multiforme, anaplastic astrocytoma, medulloblastoma) and metastatic disease (breast cancer, lung cancer, melanoma, lymphoma, leukemia).[4]
Differentiating Neoplastic Meningitis from other Diseases
Neoplastic meningitis must be differentiated from infections (meningitis, Lyme disease, neurocysticercosis), neoplastic (intracerebral metastasis, dural metastasis), inflammatory (rheumatoid arthritis, multiple sclerosis, polychondritis), and granulomatous disorders (sarcoidosis, histiocytosis, Wegener's granulomatosis, vasculitis).[5]
Epidemiology and Demographics
Neoplastic meningitis occurs in approximately 3-5% of patients with solid tumor, 5-15% of patients with leukemia, and 1-2% of patients with primary brain tumors.[6][7]
Risk Factors
There are no established risk factors for neoplastic meningitis.
Screening
There is insufficient evidence to recommend routine screening for neoplastic meningitis.[8]
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
There are no primary or secondary preventive measures available for neoplastic meningitis.
References
- ↑ 1.0 1.1 Neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 19, 2016
- ↑ Leptomeningeal metastases. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningeal-metastases. Accessed on January 20, 2016
- ↑ Berzero, Giulia; Diamanti, Luca; Di Stefano, Anna Luisa; Bini, Paola; Franciotta, Diego; Imarisio, Ilaria; Pedrazzoli, Paolo; Magrassi, Lorenzo; Morbini, Patrizia; Farina, Lisa Maria; Bastianello, Stefano; Ceroni, Mauro; Marchioni, Enrico (2015). "Meningeal Melanomatosis: A Challenge for Timely Diagnosis". BioMed Research International. 2015: 1–6. doi:10.1155/2015/948497. ISSN 2314-6133.
- ↑ Pathology of leptomeningeal metastases. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningeal-metastases. Accessed on January 19, 2016
- ↑ Leptomeningitis. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningitis. Accessed on January 21, 2016
- ↑ Gleissner, Beate; Chamberlain, Marc Charles (2006). "Neoplastic meningitis". The Lancet Neurology. 5 (5): 443–452. doi:10.1016/S1474-4422(06)70443-4. ISSN 1474-4422.
- ↑ Hayat, M. A. Brain metastases from primary tumors : epidemiology, biology, and therapy. London: Elsevier/Academic Press, 2014. Print.| url=https://books.google.com/books?id=IloXAwAAQBAJ&pg=PA43&lpg=PA43&dq=leptomeningeal+carcinomatosis+is+present+in+1-5%25+of+patients+with+solid+tumors,+5-15%25+of+patients+with+leukemia,+and+1-2%25+of+patients+with+primary+brain+tumors.&source=bl&ots=ehEaDBCT5f&sig=vvSxdxDjNMBe0CdCP6fEcMaYJqU&hl=en&sa=X&ved=0ahUKEwi2ueuw37bKAhUG8j4KHWUUCoIQ6AEILTAC#v=onepage&q=leptomeningeal%20carcinomatosis%20is%20present%20in%201-5%25%20of%20patients%20with%20solid%20tumors%2C%205-15%25%20of%20patients%20with%20leukemia%2C%20and%201-2%25%20of%20patients%20with%20primary%20brain%20tumors.&f=false. Accessed on January 19, 2016
- ↑ Early detection, diagnosis, and staging of brain tumors. American cancer society. http://www.cancer.org/cancer/braincnstumorsinadults/detailedguide/brain-and-spinal-cord-tumors-in-adults-detection