Neoplastic meningeosis as connection with CNS involvement by solid tumors. Consequences for diagnosis and treatment

Neoplastic meningeosis is a disseminated manifestation of solid tumors within the CNS and is associated with a particularly poor prognosis. Early diagnosis is often complicated by heterogeneous neurologic symptoms. Although solid parenchymatous brain metastases are often found concurrently, several particularities in diagnosis and treatment of neoplastic meningeosis need to be observed. Contrast-enhanced MRI including the spine and cytologic analysis of cerebrospinal fluid are of particular importance. Different therapeutic options need to be considered depending on the manifestation of meningeosis as either solid leptomeningeal lesions or circulating non-adhesive tumor cells including concomitant systemic tumor manifestations. These options include radiotherapy, intrathecal or systemic chemotherapy and supportive care measures. The treatment guidelines for neoplastic meningeosis published by the neurooncological working group of the German cancer aid can form a basis for decision-making.     «

Neoplastic meningeosis is a disseminated manifestation of solid tumors within the CNS and is associated with a particularly poor prognosis. Early diagnosis is often complicated by heterogeneous neurologic symptoms. Although solid parenchymatous brain metastases are often found concurrently, several particularities in diagnosis and treatment of neoplastic meningeosis need to be observed. Contrast-enhanced MRI including the spine and cytologic analysis of cerebrospinal fluid are of particular impo...     »