Leptomeningeal Metastases in Solid Tumors

Abstract

BACKGROUND: Leptomeningeal metastases are diagnosed in 1% to 8% of patients with cancer. The most common histology is leukaemia, lymphoma, breast carcinoma, lung carcinoma and melanoma. The aim of this study is to show the appearance of leptomeningeal metastases in lung and breast cancer with specific biological features.AIM: The study is a review of two cases - breast and lung carcinoma with specific biological features who eventually have developed leptomeningeal metastases.CASE PRESENTATION: Although CNS metastasis most commonly occurs in those with known systemic metastases, our patient had biological indolent disease (nor hormone negative or HER 2 positive and no metastatic disease) and still LM did occur. LM remains a devastating complication of cancer with classic presentation with multifocal neurologic signs and symptoms (like the case with lung cancer), but many patients also have evidence of impaired CSF flow, and hydrocephalus may be the only presenting manifestation of LM.CONCLUSION: The prognostic factors associated with survival in patients with LM metastasis are not certain as well as right treatment for these patients which is still a big challenge. Due to the lack of randomized studies and especially of studies referring to one specific primary tumor, there is currently no generally accepted standard of care in the treatment of LM metastases.