The diagnostic and therapeutic management of leptomeningeal carcinomatosis.

The infiltration of the leptomeninges by malignant cells is not an uncommon complication of cancer and is called carcinomatous meningitis or leptomeningeal carcinomatosis (LC). Carcinomatous meningitis arises from either solid tumours or haematological malignancies. In general, LC represents a devastating metastatic complication of systemic malignant disease with a dismal prognosis and increased mortality. The diagnosis is made by both lumbar puncture and radiological investigation, mainly magnetic resonance imaging (MRI). The most common associated malignancies are breast and lung cancer, melanoma, lymphomas and leukaemias [1, 2]. The therapeutic management of LC includes intrathecal administration of chemotherapy and radiotherapy. The treatment of LC remains controversial and no straighforward guidelines exist in the literature. The present article reviews the incidence, pathogenesis, clinical presentation, diagnosis and treatment of LC in all malignancies.