obsolete leptomeningeal neoplasm

Leptomeningeal Neoplasm: An Obsolete Term

The term "leptomeningeal neoplasm" is no longer used in modern medical literature to describe a specific type of tumor. However, based on the provided context, it appears that this term was once used to refer to a malignant neoplasm that has spread from its original site of growth to the leptomeninges (the protective membranes surrounding the brain and spinal cord).

Current Understanding

The current understanding is that tumors that have spread to the leptomeninges are referred to as leptomeningeal carcinomatosis, carcinomatous meningitis, or malignant leptomeningeal neoplasm. These terms describe a condition where cancer cells from a primary tumor site have disseminated to the meninges, leading to an inflammatory response.

Key Points

• Leptomeningeal neoplasm is an obsolete term.
• Tumors that have spread to the leptomeninges are referred to as leptomeningeal carcinomatosis or carcinomatous meningitis.
• This condition involves cancer cells from a primary tumor site disseminating to the meninges, leading to inflammation.

References

• [1] The 2021 fifth edition introduces major changes that advance the role of molecular diagnostics in CNS tumor classification. (Source: [2])
• [3] Tumors in this diagnostic category show varying degrees of morphologic and/or immunophenotypic evidence of neuronal or glial and neuronal differentiation. This is relevant to understanding the current classification of tumors. (Source: [3])
• Leptomeningeal carcinomatosis, also known as "leptomeningeal metastasis" or "carcinomatosis meningitis," is involvement by cancer of the pia and arachnoid mater of the brain with the subarachnoid space in between. (Source: [11])
• Leptomeningeal disease (LMD; also referred to as leptomeningeal metastases or carcinomatous meningitis) is a rare but frequently devastating complication of advanced cancer from solid tumors, mostly commonly lung cancer, breast cancer, and melanoma. (Source: [12])

Diagnostic Tests for Leptomeningeal Disease

Leptomeningeal disease, a condition where cancer cells spread to the protective membranes surrounding the brain and spinal cord, can be challenging to diagnose. However, several diagnostic tests can help confirm the presence of this condition.

• Magnetic Resonance Imaging (MRI): MRI scans of the brain and

Treatment Options for Leptomeningeal Metastasis

Leptomeningeal metastasis (LM) is a serious complication of cancer that affects the meninges, the protective membranes surrounding the brain and spinal cord. While there are no curative treatments available, various drug therapies can help manage symptoms and improve quality of life.

Intrathecal Pharmacotherapy

• Intrathecal administration of chemotherapy agents such as methotrexate (MTX), cytarabine (Ara-C), and thiotepa has been shown to be effective in treating LM [1, 11].
• These drugs can be delivered directly into the spinal canal to target cancer cells in the leptomeninges [3].

Systemic Pharmacotherapy

• Systemic chemotherapy agents such as liposomal cytarabine have also been used to treat LM, with some studies showing improved progression-free survival [9].
• However, systemic therapy may not be effective in all cases, and intrathecal administration is often preferred for its targeted approach.

Focal Radiotherapy

• Focal radiotherapy can be used to target specific areas of cancer involvement in the leptomeninges, helping to reduce symptoms and improve quality of life [2].
• This treatment option is particularly useful when combined with other therapies, such as chemotherapy or surgery.

Recent Advances

• Recent studies have shown that adding intrathecal liposomal cytarabine to standard therapy can improve progression-free survival in patients with LM [9].
• Further research is needed to fully understand the benefits and limitations of these treatment options.

While drug treatments for leptomeningeal metastasis are available, it's essential to note that each patient's response may vary. A multidisciplinary approach involving a team of healthcare professionals can help determine the best course of treatment for individual cases.

References:

[1] - [15] refer to the context provided above.

Differential Diagnosis of Leptomeningeal Neoplasms

Leptomeningeal neoplasms, also known as carcinomatous meningitis or leptomeningeal metastases, are a type of cancer that involves the meninges, the protective membranes surrounding the brain and spinal cord. When diagnosing leptomeningeal neoplasms, it's essential to consider various differential diagnoses to ensure accurate identification.

Common Differential Diagnoses

• Sarcoidosis: A rare autoimmune disorder that can cause inflammation in the meninges, leading to symptoms similar to those of leptomeningeal neoplasms.
• Tuberculosis: A bacterial infection that can affect the central nervous system and mimic the symptoms of leptomeningeal neoplasms.
• Lymphoma: A type of cancer that affects the immune system and can involve the meninges, leading to similar symptoms as leptomeningeal neoplasms.
• Metastatic disease: Cancer that has spread from another part of the body to the brain or spinal cord, which can be mistaken for leptomeningeal neoplasms.

Other Differential Diagnoses

• Infections: Such as meningitis caused by bacteria, viruses, or fungi, which can present with similar symptoms to leptomeningeal neoplasms.
• Autoimmune disorders: Like multiple sclerosis, which can cause inflammation in the meninges and mimic the symptoms of leptomeningeal neoplasms.

Diagnostic Challenges

Diagnosing leptomeningeal neoplasms can be challenging due to their rarity and nonspecific symptoms. A high index of suspicion is often required, along with a combination of clinical, laboratory, and imaging findings to confirm the diagnosis.

• Imaging studies: Such as MRI or CT scans, which can show abnormalities in the meninges and surrounding brain tissue.
• **Cerebrospinal fluid (CSF)