Carcinomatous/Neoplastic Meningitis

Many tumors arising outside the nervous system can travel to the the linings of the brain and spinal cord. Terms for the condition vary (carcinomatous meningitis, neoplastic meningitis, leptomeningeal metastasis). Symptoms from neoplastic meningitis include pain, headaches, mental status decline, loss of sensation in the face or elsewhere on the body, or difficulties with vision, hearing, or swallowing, among others. Diagnosis is made by lumbar puncture (spinal tap), though MRI can be helpful. Often, more than one lumbar puncture is necessary to make a diagnosis. The treatment of neoplastic meningitis depends on the type of tumor and prior treatment. Initial treatment can consist of:

Use of chemotherapy injected directly into the spinal fluid (intrathecal chemotherapy).

Chemotherapy can be injected via lumbar puncture or into a special reservoir inserted into the ventricles, the normal fluid filled cavities of the brain

Radiation therapy alone. Local radiation therapy may be applied to symptomatic areas.

For some types of tumors, usually those sensitive to chemotherapy such as lymphoma, systemic chemotherapy may be an alternative to intrathecal therapy.

	Use of chemotherapy injected directly into the spinal fluid (intrathecal chemotherapy).
	Chemotherapy can be injected via lumbar puncture or into a special reservoir inserted into the ventricles, the normal fluid filled cavities of the brain
	Radiation therapy alone. Local radiation therapy may be applied to symptomatic areas.
	For some types of tumors, usually those sensitive to chemotherapy such as lymphoma, systemic chemotherapy may be an alternative to intrathecal therapy.