Neoplastic meningitis: Difference between revisions
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* The pathophysiology of neoplastic meningitis involves spread of cancer cells to the meninges and subarachnoid space. The location could be the brain or the spinal cord. It could be from a distant source or from a primary CNS tumor (drop metastasis). | * The pathophysiology of neoplastic meningitis involves spread of cancer cells to the meninges and subarachnoid space. The location could be the brain or the spinal cord. It could be from a distant source or from a primary CNS tumor (drop metastasis). | ||
* Cancer from a distant source enter the CSF by means of the following:[https://en.wikipedia.org/wiki/Neoplastic_meningitis] | * Cancer from a distant source enter the CSF by means of the following:[https://en.wikipedia.org/wiki/Neoplastic_meningitis] | ||
** Hematogenous Spread - cancer cells invade blood vessels to reach the subarachnoid space through the systemic arterial circulation or by the Batsons venous plexus. | ** Hematogenous Spread from a distant primary tumor site - cancer cells produce enzymes that allows them to microscopically invade blood vessels to reach the subarachnoid space through the systemic arterial circulation or by the Batsons venous plexus. | ||
** Infiltration to the spinal cord - | ** Invasion from a primary brain tumor to the meninges - when cancer cells lodge into small arteries causing local ischemia and blood vessel damage leading to spillage of neoplastic cells to the Virchow-Robin spaces thereby providing access to the subarachnoid space. | ||
** Cancer spread a neural pathways to reach the meninges | ** Infiltration to the spinal cord - Cancer cells gain access to the subarachnoid space through this route via the perivascular tissues the surround the blood vessels at the brain entrance. Direct infiltration of the spinal nerve roots (dorsal and ventral) has also been documented. | ||
** Cancer spread a neural pathways to reach the meninges - The CSF carries cancer cells through the brain tracts | |||
** Iatrogenic - from surgical procedures involving removal of a primary brain tumor | ** Iatrogenic - from surgical procedures involving removal of a primary brain tumor | ||
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[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Neurosurgery]] | [[Category:Neurosurgery]] | ||
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Revision as of 15:53, 15 May 2019
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Neoplastic meningitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Neoplastic meningitis On the Web |
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American Roentgen Ray Society Images of Neoplastic meningitis |
For patient information, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Synonyms and keywords: NM; Carcinomatous meningitis; Leptomeningeal carcinomatosis; LC; Neoplastic arachnoiditis; Malignant meningitis; Leptomeningeal neoplasia, Meningeal carcinomatosis; Meningeosis neoplastica; Meningitis carcinomatosa; Leptomeningeal metastasis; Leptomeningeal metastases; Carcinomatous meningitis; Subarachnoid space metastasis; Subarachnoid space metastases
Overview
Historical Perspective
Classification
Pathophysiology
- The pathophysiology of neoplastic meningitis involves spread of cancer cells to the meninges and subarachnoid space. The location could be the brain or the spinal cord. It could be from a distant source or from a primary CNS tumor (drop metastasis).
- Cancer from a distant source enter the CSF by means of the following:[3]
- Hematogenous Spread from a distant primary tumor site - cancer cells produce enzymes that allows them to microscopically invade blood vessels to reach the subarachnoid space through the systemic arterial circulation or by the Batsons venous plexus.
- Invasion from a primary brain tumor to the meninges - when cancer cells lodge into small arteries causing local ischemia and blood vessel damage leading to spillage of neoplastic cells to the Virchow-Robin spaces thereby providing access to the subarachnoid space.
- Infiltration to the spinal cord - Cancer cells gain access to the subarachnoid space through this route via the perivascular tissues the surround the blood vessels at the brain entrance. Direct infiltration of the spinal nerve roots (dorsal and ventral) has also been documented.
- Cancer spread a neural pathways to reach the meninges - The CSF carries cancer cells through the brain tracts
- Iatrogenic - from surgical procedures involving removal of a primary brain tumor
Causes
- Neoplastic meningitis is a secondary cancer caused by the spread of tumor cells into the meninges and subarachnoid space from a primary source. Most common sources documented are breast, lung, melanoma and hematologic cancers mostly acute lymphocytic leukemia. Cancers not previously thought to be predisposed to neoplastic meningitis but now has documented cases are gastric, prostate, ovarian, cervical and endometrial. [4]
Differentiating Neoplastic Meningitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
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 | Cost-Effectiveness of Therapy | Future or Investigational Therapies