Page 13 - Read Online

Chu et al. Meningeal carcinomatosis: a retrospective analysis

obvious reinforcement. The leptomeningeal abnormal early diagnostic rate of the disease and help clinicians
reinforcement may be due to the direct infiltration of develop a detailed and suitable treatment plan for
tumor cells from dura or from choroid plexus. Enhanced patients to increase benefit.
scan can discover more abnormal meninges, which
play an important role in the auxiliary diagnosis of MC. Financial support and sponsorship
Nil.
Serum tumor markers have important significance
for the source of the tumor. Tumor markers can have Conflicts of interest
different levels in different clinical periods and can There are no conflicts of interest.
reflect the dynamic changes, recurrence, metastasis,
or treatment effect of the tumor. The abnormal rate Patient consent
of serum tumor markers is 84% in our study. The Informed consent was obtained from all individual
erythrocyte sedimentation rate, in some physiological participants included in the study.
conditions, such as anemia, menstrual period, after
three months of pregnancy, infection, malignant Ethics approval
tumor, tissue necrosis and other diseases, was found This study was approved by the ethics committee of
increased. The change is not specific, but has great the First Hospital of Jilin University.
value for malignant tumors fast development.
REFERENCES
Most patients with MC have primary tumor. However, in
some patients with CNS damage as the first symptom 1. Mittica G, Senetta R, Richiardi L, Rudà R, Coda R, Castellano I,
Sapino A, Cassoni P. Meningeal carcinomatosis underdiagnosis
no primary tumor is found, or is found only after a and overestimation: incidence in a large consecutive and unselected
period of time. In this study, primary tumor incidence population of breast cancer patients. BMC Cancer 2015;15:1021.
in patients is consistent with the incidence of MC in 2. Thiel E, Gleissner B. Neoplastic meningitis. Dtsch Arztebl
[4]
China and the most common is lung cancer. 3. 2006;103:2559-65.
Chamberlain MC. Neoplastic meningitis. Oncologist 2008;13:967-77.
4. DeAngelis LM. Diagnosis and treatment of leptomeningeal metastasis.
Literature reported that untreated patients with MC Educational Book Am Soc Clini Oncol 2002;369:374.
survive for 4-6 weeks whereas patients undergoing 5. Van Horn A, Chamberlain MC. Neoplastic meningitis. J Support
Oncol 2012;10:45-53.
regular treatment survive for 4-6 months. In this 6. Chamberlain MC. Leptomeningeal metastasis. Curr Opin Oncol
[14]
study, the difference was not statistically significant 2010;22:627-35.
when the survival of patients with radiotherapy 7. Olson ME, Chernik NL, Posner JB. Infiltration of the leptomeninges
and chemotherapy was compared with symptomatic by systemic cancer. A clinical and pathologic study. Arch Neurol
1974;30:122-37.
treatment patients. Although patients with MC received 8. Kato Y, Takeda H, Dembo T, Fukuoka T, Tanahashi N. Progressive
intrathecal injection of chemotherapy and whole brain multiple cranial nerve palsies as the presenting symptom of meningeal
radiotherapy, the treatment did not improve survival. carcinomatosis from occult colon adenocarcinoma. Intern Med
Because MC is considered the terminal stage of the 9. 2012;51:795-7.
Nardone R, Herz M, Egarter-Vigl E, Tezzon F. Isolated oculomotor
disease, concurrent chemoradiation has no impact on nerve palsy as the presenting clinical manifestation of a meningeal
patient outcome, but can improve clinical symptoms. [15] carcinomatosis: a case report. Neurol Sci 2006;27:288-90.
10. Taillibert S, Laigle-Donadey F, Chodkiewicz C, Sanson M, Hoang-
Xuan K, Delattre JY. Leptomeningeal metastases from solid
In this study, the clinical manifestations of 77 patients malignancy: a review. J Neurooncol 2005;75:85-99.
are diverse, but most of them are characterized 11. Gao W, Li Z, Wang LM, Lian F, Liu CC, Lu DH, Piao YS. The clinical
by increased intracranial pressure symptoms such and pathological features of 85 cases with positive cerebrospinal fluid
as headache, nausea and vomit. Therefore, when cytology by thin-layer centrifugal cytological test. Zhonghua Nei Ke
Za Zhi 2016;55:945-9. (in Chinese)
patients have above symptoms, we should be vigilant 12. Shi Q, Pu CQ, Huang XS, Tian CL, Cao XT. Optimal cut-off values
about MC and improve the head MRI and enhanced for tumor markers in cerebrospinal fluid with ROC curve analysis.
Front Biosci (Elite Ed) 2011;3:1259-64.
MRI scan, if necessary. CSF cytological examination 13. Lyu Y, Li C, Zhou X, He W, Lyu P, Zhou Z, Wang D, Ning F, Wang Y.
is the gold standard of the diagnosis of MC. Because MR image analysis of 147 cases of meningeal tuberculosis. Zhonghua
CSF tumor marker has not been regarded as a Jie He He Hu Xi Za Zhi 2015;38:815-20. (in Chinese)
standard criterion of diagnosis and due to the lack of 14. Lin N, Dunn IF, Glantz M, Allison DL, Jensen R, Johnson MD,
a recognized standard reference value, its application Friedlander RM, Kesari S. Benefit of ventriculoperitoneal cerebrospinal
fluid shunting and intrathecal chemotherapy in neoplastic meningitis:
is still restricted. However, since tumor markers have a retrospective, case-controlled study. J Neurosurg 2011;115:730-6.
significant implications for primary tumor source, 15. Palma JA, Fernandez-Torron R, Esteve-Belloch P, Fontes-Villalba
combining this with serum tumor markers examination A, Hernandez A, Fernandez-Hidalgo O, Gallego Perez-Larraya J,
Martinez-Vila E. Leptomeningeal carcinomatosis: prognostic value of
would contribute to identify the source of tumor cells. clinical, cerebrospinal fluid, and neuroimaging features. Clin Neurol
Through the analysis of MC, we hope to improve the Neurosurg 2013;115:19-25.
Neuroimmunology and Neuroinflammation ¦ Volume 4 ¦ January 20, 2017 5