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Leptomeningeal carcinomatosis

Yanfang Ju, Shengjie Sun, Jinliang Wang, Shunchang Jiao
Leptomeningeal metastasis (LM) carries a devastating prognosis. Treatment selection is limited for patients with LM. We introduced to use nimotuzumab (also known as h-R3) for treating LM of nonsmall cell lung cancer. Here, we report two patients in our treatment who had prolonged overall survival over 1 year each. The pressure of cerebrospinal fluid of the patients decreased remarkably after intrathecal therapy. Symptoms of the patients had been improved quickly after one or two times of intrathecal therapy...
October 2016: Journal of Cancer Research and Therapeutics
Seema Gulia, Sudeep Gupta, Ashish Singh
There has been recent increase in incidence of leptomeningeal carcinomatosis, possibly due to widespread use of adjuvant trastuzumab and its known poor CNS penetration. Currently there are limited therapeutic options for these patients and outcome is poor. We report two cases of women with HER2 positive breast cancer who developed leptomeningeal carcinomatosis for which they were treated with intrathecal trastuzumab in combination with systemic therapy. Both patients had rapid symptomatic benefit and radiological response and remained progression free for at least seven months...
July 2016: Indian Journal of Medical and Paediatric Oncology
Sean Bemanian, Viswanath Aluru, Pouyan Gohari, Marc Ross
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Alvin J X Lee, Rachel Benamore, Monika Hofer, Meenali Chitnis
A 60-year-old male was diagnosed with T3, N3, M1b epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma. Five months later he developed significant headaches, weakness and numbness of the left leg, and unsteadiness of gait. Magnetic resonance imaging (MRI) brain demonstrated subtle gyral enhancement indicative of early leptomeningeal infiltration. He was commenced on second-line erlotinib which improved his lower limb symptoms. Three months later he developed increased urinary frequency and redeveloped leg symptoms...
September 2016: Oxford Medical Case Reports
Akimasa Sekine, Terufumi Kato, Tae Iwasawa, Tomohisa Baba, Akihiro Suido, Haruyasu Sakuranaka, Masaaki Futaki, Takashi Ogura
We herein report a case of a 67-year-old woman previously treated with erlotinib for adenocarcinoma with an epidermal growth factor receptor (EGFR) mutation in exon 19, which rapidly developed to progressive symptomatic leptomeningeal carcinomatosis. The primary tumor and lung metastases also worsened and the performance status (PS) score declined to 3. With a re-biopsy from the pulmonary metastases, the T790M mutation was detected by the cobas EGFR mutation test, but not the cycleave test, although an exon 19 deletion was detected by both of the tests...
2016: Internal Medicine
Jung Geun Ji, Joo Won Chung, Seung Woo Nam, Seung Kyu Choi, Dong Won Lee, Dae In Kim, Byung Gwan Jeon, Yun Jae Shin
Leptomeningeal carcinomatosis (LMC) is rare metastatic form of gastric cancer. Most cases are diagnosed in the final stage after multiple distant metastasis. An 84-year-old woman was admitted with melena, headache and vomiting. Esophagogastroduodenoscopy showed an ulceroinfiltrating lesion at the stomach (Borrmann class III), and biopsy revealed a signet ring cell carcinoma. The abdominal-pelvic CT showed no evidence of metastasis. A sudden decrease of consciousness was noted, but the brain CT showed no active lesion while the brain MRI revealed enhancement of leptomeninges...
August 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Shaan Dudani, Sasha Mazzarello, John Hilton, Brian Hutton, Lisa Vandermeer, Ricardo Fernandes, Mohammed F K Ibrahim, Stephanie Smith, Habeeb Majeed, Khalid Al-Baimani, Jean-Michel Caudrelier, Risa Shorr, Mark Clemons
The incidence of leptomeningeal carcinomatosis in breast cancer patients (LC-BC) is increasing. Despite significantly affecting patient quality of life (QoL) and overall survival (OS), little is known about its optimal management. A systematic review of treatment strategies for LC-BC was performed. EMBASE, Ovid Medline, Pubmed, and the Cochrane Central Register of Controlled Trials were searched from 1946 to 2015 for trials reporting on treatments for LC-BC. All treatment modalities and study types were considered...
July 28, 2016: Clinical Breast Cancer
Keith Sacco, Aun Muhammad, Waqar Saleem, Heba Alshaker, Leonardo Monzon, Mohammad Rafiqul Islam, Dmitri Pchejetski
Leptomeningeal metastasis (LM) is an uncommon presentation of relapse in breast cancer, which is associated with poor clinical outcomes and poor prognosis. Notably, LM most commonly occurs in breast cancer. The aim of the present review was to investigate the occurrence of LM as the primary presentation of relapse following remission in breast cancer patients and to determine whether specific histological subtypes are predisposed to meningeal metastases. In addition, the present review evaluated whether patients presenting with LM as the primary site of relapse exhibit differences in survival when compared with patients exhibiting metastasis to other sites...
August 2016: Oncology Letters
Dae-Won Lee, Kyung-Hun Lee, Jin Wook Kim, Bhumsuk Keam
Leptomeningeal carcinomatosis (LMC) is the multifocal seeding of cerebrospinal fluid and leptomeninges by malignant cells. The incidence of LMC is approximately 5% in patients with malignant tumors overall and the rate is increasing due to increasing survival time of cancer patients. Eradication of the disease is not yet possible, so the treatment goals of LMC are to improve neurologic symptoms and to prolong survival. A standard treatment for LMC has not been established due to low incidences of LMC, the rapidly progressing nature of the disease, heterogeneous populations with LMC, and a lack of randomized clinical trial results...
2016: International Journal of Molecular Sciences
Elizabeth Dudnik, Shlomit Yust-Katz, Hovav Nechushtan, Daniel A Goldstein, Alona Zer, Dov Flex, Tali Siegal, Nir Peled
Central nervous system (CNS) metastases occur in 30% of patients with advanced non-small cell lung cancer (NSCLC). Localized treatments targeting CNS metastases result in delays in systemic therapy administration and are associated with neurocognitive impairment. Nivolumab is an immune check-point inhibitor that is approved as a second-line treatment of NSCLC. Data regarding the intracranial activity of nivolumab is lacking. We retrospectively reviewed the efficacy and safety of nivolumab in five patients with advanced NSCLC and new/progressing intracranial metastases...
August 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Yurday Ozdemir, Berna Akkus Yildirim, Erkan Topkan
To assess the efficacy of whole-brain radiotherapy (WBRT) and prognostic factors in leptomeningeal carcinomatosis (LMC) of non-small-cell lung cancer (NSCLC) patients. WBRT records of 51 LMC patients confined to brain were reviewed. Eligible patients had squamous-cell carcinoma (SCC) or adenocarcinoma, and Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-3. The WBRT was either 20 or 30 Gray. The primary and secondary objectives were to determine overall survival (OS) and prognostic factors for improved treatment response, respectively...
September 2016: Journal of Neuro-oncology
Gorana Mandić Stojmenović, Aleksandra M Pavlović, Milica Skender Gazibara, Danica Grujicić, Aleksandra Radojicić, Nadezda Covicković Sternić
INTRODUCTION: Leptomeningeal carcinomatosis (LC) is a serious complication occuring in solid cancer patients with rather poor prognosis. CASE REPORT: We presented a 47-year-old woman with the 6-month history of diffuse headache, nausea and visual obscuration. Initially, clinical status and brain magnetic resonance imaging (MRI) indicated syndrome of idiopathic intracranial hypertension. Due to clinical progression and high papillary stasis, cerebrospinal fluid (CSF) examination was performed only after ventriculoperitoneal shunt was implanted...
March 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Inna V Fedorenko, Brittany Evernden, Rajappa S Kenchappa, Solmaz Sahebjam, Elena Ryzhova, John Puskas, Linda McIntosh, Gisela Caceres, Anthony Magliocco, Arnold Etame, J William Harbour, Keiran S M Smalley, Peter A Forsyth
Uveal melanoma is a rare subtype of melanoma, accounting for only 3-5% of all melanoma cases in the USA. Although fewer than 4% of uveal melanoma patients present with metastasis at diagnosis, approximately half will develop metastasis, more than 90% of which disseminate to the liver. Infrequently, a number of malignancies can lead to leptomeningeal metastases, a devastating and terminal complication. In this case report, we present an exceedingly rare case of a patient with uveal melanoma who developed leptomeningeal carcinomatosis as the sole site of metastasis...
October 2016: Melanoma Research
Sharareh Nina Akbar, David Jacob Hermel, Gustavo Alday
Esophageal cancer is one of the rarer solid tumors that metastasize to the central nervous system. We describe a case of a 57-year-old male, previously confirmed to have obstructive esophageal adenocarcinoma with local mediastinal and esophagogastric lymph node involvement undergoing chemotherapy, who presented with altered mental status, headache, nausea, 15-pound weight loss, and neck stiffness. Prior staging with an MRI of the brain and spine was unrevealing, but a lumbar puncture demonstrated adenocarcinomatous spread to the cerebrospinal fluid, consistent with leptomeningeal carcinomatosis...
April 2016: Connecticut Medicine
Muneera Majed Almajed, Khashayar Esfahani, Manuela Pelmus, Lawrence Panasci
Leptomeningeal carcinomatosis carries a poor prognosis in breast cancer. Treatment modalities are geared towards tumour molecular characteristics, as well as symptoms and patient performance status. It has previously been postulated that endocrine treatments used for the treatment of metastatic breast cancer do cross the blood-brain barrier and can achieve antineoplastic effects in the central nervous system. We report a case of metastatic breast cancer in a 65-year-old woman who developed leptomeningeal carcinomatosis...
2016: BMJ Case Reports
Amal Alkhotani, Nouf Alrishi, M Salem Alhalabi, Tahira Hamid
Leptomeningeal carcinomatosis (LMC) is a diffuse or multifocal malignant infiltration of the pia matter and arachnoid membrane. The most commonly reported cancers associated with LMC are breast, lung, and hematological malignancies. Patients with LMC commonly present with multifocal neurological symptoms. We report a case of LMC secondary to gastroesopha-geal junction cancer present initially with cauda equina syndrome. A 51-year-old male patient with treated adenocarcinoma of the gastroesophageal junction presented with left leg pain, mild weakness, and saddle area numbness...
January 2016: Case Reports in Neurology
Xi Wu, Junling Li, Jianping Xiao, Boyan Yang, Lei Yu, Xiaoming Wu, Jinghai Wan, Haiyan Xu, Jianxin Kong
BACKGROUND: Leptomeningeal carcinomatosis is a rare type of metastatic tumors of the central nervous system. In recent years, with the improvement of neoplasms therapies and longer survival of patients by better systemic control, incidence of leptomeningeal metastases has increased every year. However, there is still lack of effective therapies. The aim of this study is to investigate the efficacy, security and prognosis of intrathecal chemotherapy with methotrexate (MTX) in the treatment of neoplastic meningitis...
May 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Anusha Venkataraman, Bijnya Birajita Panda, K Nagarajan
No abstract text is available yet for this article.
March 2016: Indian Journal of Ophthalmology
Rohit Aiyer, Ester Engelman, Wei Xue, Edward Yu
A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina...
2016: BMJ Case Reports
H Pluchart, E Jacquet, D Charlety, B Allenet, P Bedouch, M Mousseau
We report the case of a woman with metastatic breast cancer receiving intrathecal trastuzumab (and intravenous trastuzumab for more than 7 years). She was diagnosed in 2001 with a duct invasive breast cancer T3N1M0 HER2 (human epidermal growth factor receptor 2)-positive +++ HR (hormone receptor) -negative. She received chemotherapy and then she had a mastectomy. Several metastases were discovered and treated from 2003 to 2008 with chemotherapy. In March 2010, brain metastases and a leptomeningeal carcinomatosis from her HER2-positive breast cancer appeared...
April 4, 2016: Targeted Oncology
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