leptomeningeal disease
Cancer spread to the cerebrospinal fluid spaces and meningeal surfaces, also called carcinomatous meningitis, with poor prognosis.
Full Definition
Leptomeningeal disease, also known as carcinomatous meningitis or neoplastic meningitis, refers to the spread of cancer cells to the cerebrospinal fluid (CSF) spaces and the pia and arachnoid meningeal layers. This condition can result from direct extension of brain or spine tumors, hematogenous dissemination, or seeding during surgical procedures. Diagnosis relies on CSF cytology, neuroimaging showing enhancement of meningeal surfaces, and clinical symptoms including headache, altered mental status, and cranial nerve deficits. Leptomeningeal disease carries a poor prognosis with median survival typically measured in weeks to months, and treatment options include intrathecal chemotherapy, radiation therapy, and systemic agents with CSF penetration.
Usage
Usage note: May abbreviate as LM in clinical notes; distinguish from infectious causes in differential diagnosis.
In Context
- "CSF analysis confirmed leptomeningeal disease with malignant cells identified on cytology." — cerebrospinal fluid report
- "Linear enhancement along the tentorium suggested possible leptomeningeal spread." — MRI interpretation