Leptomeningeal carcinomatosis, an emerging disease in internal medicine departments with a generally poor prognosis: two case reports

Published: 7 May 2024
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Authors

As a result of improved diagnostic methods and higher cancer patient survival rates, leptomeningeal carcinomatosis is being found in internal medicine departments more frequently. Melanoma, lung cancer, and breast adenocarcinoma are the three cancers that are most commonly associated. When the main tumor diffuses through the bloodstream, cerebrospinal fluid, or direct diffusion and causes multiple focal neurological symptoms, it is known as leptomeningeal involvement; the prognosis is usually not good. Despite multimodal treatment, leptomeningeal carcinomatosis is an advanced form of cancer that frequently results in rapid death. Treatment is typically palliative and consists primarily of intrathecal or systemic radiation and/or chemotherapy. New experimental therapies and immunotherapy are promising means of lowering morbidity and mortality. Clinical cases of leptomeningeal carcinomatosis are reported; both cases were identified at the Ospedale dei Castelli’s Department of Internal Medicine and resulted from primary breast pathology.

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Citations

Fizazi K, Asselain B, Vincent-Salomon A, et al. Meningeal carcinomatosis in patients with breast carcinoma. Clinical features, prognostic factors, and results of a high-dose intrathecal methotrexate regimen. Cancer 1996;77:1315-23. DOI: https://doi.org/10.1002/(SICI)1097-0142(19960401)77:7<1315::AID-CNCR14>3.0.CO;2-4
Dommasch D, Przuntek H, Grüninger W, Mertens HG. Intrathecal cytostatic chemotherapy of meningitis carcinomatosa. Clinical manifestation and cerebrospinal fluid cytology in a case of metastatic carcinoma of the breast. Eur Neurol 1976;14:178-91. DOI: https://doi.org/10.1159/000114739
Bhambhvani HP, Rodrigues AJ, Umeh-Garcia MC, Hayden Gephart M. Leptomeningeal carcinomatosis: molecular landscape, current management, and emerging therapies. Neurosurg Clin N Am 2020;31:613-25. DOI: https://doi.org/10.1016/j.nec.2020.06.010
Moseley RP, Davies AG, Richardson RB, et al. Intrathecal administration of 131I radiolabelled monoclonal antibody as a treatment for neoplastic meningitis. Br J Cancer 1990;62:637-42. DOI: https://doi.org/10.1038/bjc.1990.345
McKelvey EM. Meningeal involvement with metastatic carcinoma of the breast treated with intrathecal methotrexate. Cancer 1968;22:576-80. DOI: https://doi.org/10.1002/1097-0142(196809)22:3<576::AID-CNCR2820220313>3.0.CO;2-C
Kordbacheh T, Law WY, Smith IE. Sanctuary site leptomeningeal metastases in HER-2 positive breast cancer: a review in the era of trastuzumab. Breast 2016;26:54-8. DOI: https://doi.org/10.1016/j.breast.2015.11.005
Park MJ. Durable response of leptomeningeal metastasis of breast cancer to salvage intrathecal etoposide after methotrexate: a case report and literature review. Am J Case Rep 2015;16:524-7. DOI: https://doi.org/10.12659/AJCR.894007
Wang N, Bertalan MS, Brastianos PK. Leptomeningeal metastasis from systemic cancer: Review and update on management. Cancer 2018;124:21-35. DOI: https://doi.org/10.1002/cncr.30911

How to Cite

Pietrantonio, F., Lordi, M., Vinci, F., Alessi, E., Pascucci, M., Delli Castelli, M., Vinci, A., Cipriano, E., Rosiello, F., & Ciamei, A. (2024). Leptomeningeal carcinomatosis, an emerging disease in internal medicine departments with a generally poor prognosis: two case reports. Italian Journal of Medicine, 18(2). https://doi.org/10.4081/itjm.2024.1727