Meningiosis neoplastica
| Classification according to ICD-10 | |
|---|---|
| C79.3 | Secondary malignant neoplasm of the brain and meninges |
| ICD-10 online (WHO version 2019) | |
The spread of tumor cells in the soft meninges is referred to as meningeosis neoplastica (English: leptomeningeal spread) .
It usually only occurs in the late stages of cancer and is associated with a poor prognosis. If the origin of the tumor is more precisely known, one also speaks of meningeosis carcinomatosa ( carcinoma ), sarcomatosa ( sarcoma ), gliomatosa ( glioma ), leukaemica ( leukemia ) or lymphomatosa ( lymphoma ). This is usually demonstrated by examining the cerebrospinal fluid , which is obtained by a lumbar puncture .
Therapeutic approaches
Treatment options are radiation therapy of the central nervous system (CNS) and the chemotherapy . The possibilities of chemotherapy are , however, clearly limited by the fact that only a few cytostatics can cross the blood-brain barrier and thus build up effective concentrations in the CNS. The treatment is therefore usually carried out intrathecally (i.e. the drugs are administered directly into the CSF space). In Germany, methotrexate , cytarabine and thiotepa are approved for intrathecal chemotherapy .
Imaging: Detection of focal meningiosis carcinomatosa in breast cancer in magnetic resonance imaging. The focal enrichment (light) in the sulci can be seen as a sign of arachnoid expansion on the right (left in the picture).
CSF examination: detection of tumor cells in the cerebrospinal fluid .
Pappenheim staining of a cytocentrifugate from a patient with bronchial carcinoma .
Brain biopsy: evidence of the spread of leptomeningeal tumor cell aggregates in a brain biopsy .
Hematoxylin-eosin stain.
literature
- Peter Berlit: Clinical Neurology. Springer, Heidelberg 2006, ISBN 3-540-01982-0 .
- Eckhard Thiel, Beate Gleissner: Meningeosis neoplastica . Dtsch Arztebl 2006; 103 (39): A-2559 / B-2216 / C-2137
- S2k guidelines for brain metastases and meningiosis neoplastica of the German Society for Neurology (DGN). In: AWMF online (as of 2014)
Individual evidence
- ^ S. Chowdhary, M. Chamberlain: Leptomeningeal metastases: current concepts and management guidelines. In: Journal of the National Comprehensive Cancer Network . Volume 3, Number 5, September 2005, pp. 693-703, ISSN 1540-1405 . PMID 16194457 . (Review).
