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Kastenbauer, Stefan; Wiesmann, Martin; Pfister, Helmut

doi:10.1023/a:1006448311976

Cited by 16 publications

(1 citation statement)

References 13 publications

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“…[ 6 , 7 , 10 , 14 , 21 ] To explain the pathogenesis of such an extraordinary event, several hypotheses have been formulated, including flow obstruction of small arteries by extrinsic (high subarachnoid neoplastic cell density) and/or luminal (neoplastic cell emboli) factors. [ 4 , 7 , 8 , 10 , 12 , 13 ] In our patient, once LMC was verified by biopsy, we interpreted the findings in the imaging tests as highly suggestive of vascular wall involvement of the right MCA and its branches by neoplastic cells [ Figure 1 ] as the main mechanism triggering cerebral ischemia, despite the lack of direct pathological support, since biopsy of large caliber arteries was abandoned to avoid further severe complications in the patient. Vasospasm has also been suggested as a potential cause of the angiographic changes associated with LMC,[ 7 ] so we cannot rule out that this dynamic process contributed to a certain extent to the cerebral ischemia developed by our patient.…”

Section: Discussionmentioning

confidence: 89%

Stroke secondary to leptomeningeal carcinomatosis with radiologic signs of arterial invasion

Gutiérrez

Carrasco

Ruz-Caracuel

et al. 2022

Surgical Neurology International

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Background: Compared to the general population, cancer patients are more likely to suffer from cerebral ischemia, either caused by the tumor itself or by the treatments applied. Case Description: We hereby present the clinical case of a patient treated for lung adenocarcinoma, who, years later, developed a case of the right frontal-temporal-insular ischemia secondary to leptomeningeal spread of the primary neoplasm, with an invasion of the walls of the right-middle cerebral artery and its branches. Conclusion: This should be considered an extremely rare form of recurrence of a primary solid tumor with clinical and radiological features that can mimic those of vascular inflammatory entities.

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Section: Discussionmentioning

confidence: 89%

Stroke secondary to leptomeningeal carcinomatosis with radiologic signs of arterial invasion

Gutiérrez

Carrasco

Ruz-Caracuel

et al. 2022

Surgical Neurology International

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Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor

et al. 2005

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Atypical teratoid/rhabdoid tumors (AT/RT) are highly malignant lesions of childhood that carry a very poor prognosis. AT/RT can occur in the central nervous system (CNS AT/RT) and disease in this location carries an even worse prognosis with a median survival of 7 months. In spite of multiple treatment regimens consisting of maximal surgical resection (including second look surgery), radiation therapy (focal and craniospinal), and multi-agent intravenous, oral and intrathecal chemotherapy, with or without high-dose therapy and stem cell rescue, only seven long-term survivors of CNS AT/RT have been reported, all in patients with newly diagnosed disease. For this reason, many centers now direct such patients, particularly those under 5 years of age, or those with recurrent disease, towards comfort care rather than attempt curative therapy. We now report on four children, two with newly diagnosed CNS AT/RT and two with progressive disease after multi-agent chemotherapy who are long term survivors (median follow-up of 37 months) using a combination of surgery, radiation therapy, and intensive chemotherapy. The chemotherapy component was modified from the Intergroup Rhabdomyosarcoma Study Group (IRS III) parameningeal protocol as three of the seven reported survivors in the literature were treated using this type of therapy. Our four patients, when added to the three reported survivors in the literature using this approach, suggest that patients provided this aggressive therapy can significantly alter the course of their disease. More importantly, we report on the first two survivors after relapse with multi-agent intravenous and intrathecal chemotherapy treated with this modified regimen.

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Continuous intrathecal treatment with methotrexate via subcutaneous port: implication for leptomeningeal dissemination of malignant tumors

et al. 2007

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Use of intrathecal (IT) chemotherapy combined with radiotherapy can extend survival of patients with untreated leptomeningeal dissemination of malignant tumors from one month to two to six months. The goal of the present study was to determine the effect of continuous IT (CIT) via a subcutaneous port that was placed using a neuronavigation system. Twenty patients with leptomeningeal dissemination (primary disease: 10 cancers, 6 gliomas and 4 lymphomas) were given 2-7 cycles of continuous IT (CIT) with methotrexate (MTX; 10 mg) administered into the lateral ventricle for 5 consecutive days biweekly. The concentration of MTX in the lateral ventricle was 7 to 10 x 10(-6 )M from Day 1 to 4. Response to this therapy included 6 patients with complete remission, 7 with progressive disease, and 7 with stable disease. Kaplan-Meier analysis revealed a median overall survival of 8 months while the overall survival rate for leptomeningeal specific death or for metastasis from cancer was 13 or 5 months, respectively. Complications of CIT with MTX were relatively low (<0.5%), and nausea and vomiting did not occur in any of the patients. In conclusion, CIT with 10 mg MTX via subcutaneous port for 5 days may improve the therapeutic effect and reduce the complications associated with treatment of leptomeningeal dissemination from malignant tumors. This would be a safe technique with possible implications that bear repeating more patients.

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Untitled

Cited by 16 publications

References 13 publications

Stroke secondary to leptomeningeal carcinomatosis with radiologic signs of arterial invasion

Stroke secondary to leptomeningeal carcinomatosis with radiologic signs of arterial invasion

Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor

Continuous intrathecal treatment with methotrexate via subcutaneous port: implication for leptomeningeal dissemination of malignant tumors

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