Clinical feature and image analysis of 29 cases of meningeal carcinomatosis / 解放军医学杂志

ABSTRACT

Objective To study the clinical features, laboratory results and image characteristics of meningeal carcinomatosis (MC). Methods The clinical data, laboratory and image results, and cerebrospinal fluid (CSF) findings of 29 cases diagnosed as MC were retrospectively reviewed and analyzed. Results Lung cancer is more common as the primary malignancy in MC patients [16(55.2%)]. The earliest neurological symptoms varied in MC patients, and headache was the most common symptom (58.6%), followed by epilepsy (13.8%), vision loss (10.3%), neuralgia (6.8%), hearing loss (6.8%) and hoarseness (3.4%), and a part of MC patients presented some serious complications. Examination of CSF of MC patients revealed an increase in intracranial pressure, and the presence of white blood cells, red blood cells and increased protein content, while the contents of glucose and chlorides decreased.The content of carcinoembryonic antigen (CEA) increased obviously, and CSF cytological exam was found to be positive in 26% patients. Head CT may not helpful for the diagnosis of the MC. The enhanced brain MRI scanning may reveal abnormal enhancement of piamater in 94.7% of MC patients, with diffuse enhancement in 94.4% of cases occurring mostly in piamater and subarachnoid space. Conclusions MC is an unique form of brain metastases of malignant tumor.The clinical feature are varied and lack of specificity. Enhanced brain MRI scanning and CSF examination may provide some value for diagnosis.Meningeal metastasis is one of the most critical complications resulting in high mortality. Early diagnosis of MCfollowed by enhanced treatment can prolong survival time and improve patients' prognosis.