Management of Leptomeningeal Disease From Solid Tumors.

Leptomeningeal carcinomatosis, known by a variety of names, including leptomeningeal metastases and neoplastic meningitis, indicates spread of tumor to the cerebrospinal fluid (CSF) and invasion of the subarachnoid space. The term leptomeningeal (from the Greek lepto, meaning “fine” or “slight”) describes the thin meninges, the arachnoid and the pia mater, between which the CSF is located. Although CSF metastases are a subtype of central nervous system (CNS) metastases, it is important to differentiate them from other CNS metastases such as brain[1] or dural metastases,[2] as both prognosis and management differ significantly between these neuroanatomic locations. We will discuss key concepts in the diagnosis, prognosis, and management of leptomeningeal carcinomatosis in a case-based format.