PDOC-03 CASE SERIES ON PEDIATRIC PATIENTS WITH LEPTOMENINGEAL METASTASES FROM VARIOUS PRIMARY BRAIN TUMORS: FROM CLINICAL PRESENTATIONS TO OUTCOMES

Abstract

Abstract Leptomeningeal disease (LMD), also known as carcinomatous meningitis, is when cancer cells are found in the thin layers covering the brain and spinal cord, in the spaces between these layers, or in the fluid surrounding the brain and spinal cord. In children with brain tumors, LMD is rare, occurring in about 1% to 2% of cases. It’s most commonly seen in certain types of tumors like medulloblastoma and primary central nervous system lymphoma, but it can also occur in other types such as pineoblastoma, Atypical Teratoid Rhabdoid Tumor, and both low-grade and high-grade gliomas. Although pilocytic astrocytomas, a type of low-grade glioma, seldom spread, there have been a few reported cases of them spreading to the leptomeninges. The exact prevalence of LMD in pediatric brain tumors isn’t well-documented due to differences in how it’s screened for across different types of tumors and at different stages of the disease. Improved surgical methods and various treatments targeting specific areas or affecting the whole body have resulted in better survival rates for patients with LMD. Detecting LMD early is important for treatment options. It can be found either at the same time as the primary brain tumor, when the tumor comes back, or as LMD without an initial tumor. There’s concern that procedures to divert cerebrospinal fluid might spread cancer cells. MRI scans are important for diagnosing LMD, but it can still be challenging to diagnose based on these scans alone. Usually, confirmation is done by analyzing the fluid around the brain and spinal cord for cancer cells. Given that LMD is a complex and rare complication of pediatric brain tumors, more research is needed to improve diagnosis and treatment. In this article, we’ll discuss three cases of pediatric brain tumors with LMD, including how they were diagnosed, treated, and their clinical outcomes.