Clinical features of patients with carcinomatous meningitis in the chinese population: report of 4 cases and review of literature

Abstract

Carcinomatous meningitis (CM) is a rare neurological disorder. We aim to promote the diagnostic efficiency of CM. Four patients (1 male and 3 females) who had been diagnosed with CM from June 2007 to June 2009 in our department were included in this study. The mean age of those patients was 55.25 years. Clinical presentation, magnetic resonance imaging findings, cerebrospinal fluid (CSF) and serum tumor markers were examined. CM may present with acute or subacute onset of symptoms. Intracranial hypertension and meningeal irritation were common in patients with CM. Other symptoms included neck and occipital pain, unilateral lower limb weakness and abnormalities of the cranial nerves. Other unusual symptoms included impaired vision (2 cases), bilateral sensorineural hearing loss (1 case), and continuous roaring in both ears (1 case). MRI revealed contrast enhancement in the meninges in 3 cases. CSF cytology was positive for cancer cells in 2 cases. The survival of patients ranged from 18 days to 8 months. Patients with CM may present with a variety of symptoms. Serum tumor biomarker determination, CSF cytology, and contrast-enhanced MRI scan are essential in the diagnosis of CM.