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Chu et al. Meningeal carcinomatosis: a retrospective analysis

INTRODUCTION 17.0 software (SPSS, IBM, West Grove, PA, USA).
Categorical data were presented as proportions,
Meningeal carcinomatosis (MC) is caused by the while continuous data were presented as means and
spread of cancer cells to the leptomeninges and standard deviations of means or interquartile ranges
by their dissemination within the cerebrospinal fluid depending on the distribution of the data. Differences
(CSF). MC prognosis is usually poor with a short in proportions were tested by the Chi-square tests and
[1]
survival. In recent years, several studies focused on differences in continuous variables were tested by
[2]
the early diagnosis of MC. CSF cytology combined student t-tests. For all statistical tests, P < 0.05 was
with CSF tumor markers were reported to have great considered to be significant.
value for early diagnosis and for addressing the origin
of meningeal carcinomatos. [3] RESULTS

METHODS The demographic data of MC patients
Among the 77 patients enrolled to the study, 35
Patient information were males and 42 were females. The median age
From 2003 to 2013, patients who admitted to at diagnosis was 55 years old (ranging from 2 to 76
Department of Neurology at the First Hospital of Jilin years old).
University and fulfilled the diagnostic criteria of MC
were enrolled. This retrospective study was approved Clinical manifestations and physical
[4]
by the ethics committee of the First Hospital of Jilin examination findings
University, Changchun, China. In this patient cohort, there were 36 (46.2%) cases with
acute onset, 30 (39%) cases with subacute onset and
Clinical data 11 (14.3%) cases with chronic onset. Most patients
A total of 77 patients were enrolled in our study. We were admitted to hospital with increased intracranial
collected data about the gender, age of onset, type of pressure symptoms such as headache, nausea and
onset, initial symptoms, clinical manifestations, physical vomit. Some patients showed cranial nerve or brain
examination, time and frequency of lumbar puncture, parenchyma damage symptoms and severe cases
CSF pressure, routine biochemical and cytological presented with unconsciousness or cerebralhernia.
examination results, CSF tumor markers, imaging Physical examination revealed meningeal irritation,
examinations [head computed tomography, magnetic pyramidal signs, cranial nerve paralysis, etc. The main
resonance imaging (MRI) scan and enhanced scan], symptoms and signs are shown in Table 1.
serum tumor markers, primary tumors, the interval
between primary tumor and central nervous symptoms, Lumbar puncture and CSF routine test
treatment methods and the survival time. Intracranial pressure, CSF cytology, tumor
markers and immunoglobulin
The above data was provided by the First Hospital The high lumbar puncture intracranial pressure was
of Jilin University Clinical Laboratory and Imaging observed in 56% (32/57) of cases, and 21.1% of them
Department. showed over 400 mmH O. The distribution of the
2
intracranial pressure is shown in Figure 1.
Statistics
Statistical analysis was performed using SPSS version In the first CSF cytology examination, 82.2% (60/73)

Table 1: Symptoms and signs of meningeal carcinomatosis patients
CNS involvement Number of Cranial nerve Number of Spinal and PNS Number of
symptoms and signs cases (%) involvement cases (%) involvement cases (%)
Headache, nausea and 54 (70.1) Abducens nerve palsy 10 (13.0) Bilateral limbs weakness 12 (15.6)
vomiting or paresthesia
Dizziness 21 (27.3) Oculomotor nerve paralysis 10 (13.0) Tendon reflexes diminish 11 (14.3)
or disappear
Hyperspasmia 11 (14.3) Facial paralysis 10 (13.0) Neck and shoulder pain 5 (6.5)
Mental disorders 5 (6.5) Double vision 7 (9.1) Unsteady gait 3 (3.9)
Disturbance of 3 (3.9) Hypoglossal nerve palsy 7 (9.1) Rectal bladder 1 (1.3)
consciousness dysfunction
Papilledema 4 (5.2) Decreased vision 4 (5.2) Saddle area sensory loss 1 (1.3)
Pyramidal signs 20 (26.0) Hearing loss 4 (5.2) Lasegue positive sign 1 (1.3)
Meningeal irritation 41 (53.2) Pronunciation or dysphagia 4 (5.2)
CNS: central nervous system; PNS: peripheral nervous system
2 Neuroimmunology and Neuroinflammation ¦ Volume 4 ¦ January 20, 2017