Cauda equina syndrome secondary to leptomeningeal metastases from recurrent primary peritoneal carcinoma

Zhou, Zhen; Canon, Chelsea M.; Matrai, Cathleen; Chapman‐Davis, Eloise

doi:10.3332/ecancer.2018.814

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Secondary systemic metastases preceding the onset of spine LMs were detected in 39 patients (54.9%), most frequently occurring in the brain parenchyma (38.9%) and/or regional lymph nodes (18.1%). Metastatic peritoneal seeding was described in 4 patients with gynecological neoplasms (22,50,51,63) and 1 patient with gastric adenocarcinoma (27). While primary tumors were treated with variable cancer-specific multidisciplinary strategies including surgery, adjuvant chemotherapy, and radiation, brain metastases were preferentially treated with conventional or stereotactic radiotherapy (66.7%) and/or surgical resection when feasible (60%).…”

Section: Resultsmentioning

confidence: 99%

Leptomeningeal Metastases of the Spine: A Systematic Review

et al. 2022

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Background/Aim: Leptomeningeal metastases (LMs) of the spine have complex management. We reviewed the literature on spine LMs. Materials and Methods: PubMed, EMBASE, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA guidelines to include studies of spine LMs. Results: We included 46 studies comprising 72 patients. The most frequent primary tumors were lung (19.4%) and breast cancers (19.4%). Median time from primary tumors was 12 months (range=0-252 months). Cauda equina syndrome occurred in 34 patients (48.6%). Nodular spine LMs (63.6%) were more frequent. Concurrent intracranial LMs were present in 27 cases (50.9%). Cerebrospinal fluid cytology was positive in 31 cases (63.6%). Cases were managed using palliative steroids (73.6%) with locoregional radiotherapy (55.6%) chemotherapy (47.2%), or decompressive laminectomy (8.3%). Post-treatment symptom improvement (32%) and favorable radiological response (28.3%) were not different based on treatment (p=0.966; p=0.727). Median overallsurvival was 3 months (range=0.3-60 months), not significantly different between radiotherapy and chemotherapy (p=0.217). Conclusion: Spine LMs have poor prognoses. Radiotherapy, chemotherapy, and surgery are only palliative, as described for intracranial LMs.Leptomeningeal metastases (LMs) are late-stage complications of systemic malignancies, occurring approximately in 5-10% of patients with solid and hematologic neoplasms (1, 2). Frequently manifesting with new neurological deficits, LMs may be detected at T1-contrast MRI follow-ups as nodular or diffuse meningeal enhancement, and may be confirmed with high-volume cerebrospinal fluid (CSF) taps for cytology (3,4). Several systemic therapeutic options are available, but the treatment goal remains palliation, as mean survival ranges 3-6 months (3,5,6).LMs involving the spine represent unique entities that may severely impact patients' functional status (7, 8). While diffuse spinal LMs may remain clinically silent and go undetected, nodular spinal LMs frequently compress spinal nerve roots causing radicular pain or neurological impairments (2, 9). Nodular spinal LMs may also lead to acute or progressive cauda equina syndrome, which require urgent diagnosis and management (10,11). While surgical decompression may provide prompt symptomatic relief, patients may not be good candidates due to their significant tumor burden (2, 3). In these cases, locoregional radiation, chemotherapy, and other systemic treatments may be pursued to achieve similar clinical outcomes (12, 13).Although spinal LMs pose significant challenges in the oncological care of patients with systemic metastases, only 619 This article is freely accessible online.

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Section: Resultsmentioning

confidence: 99%

Leptomeningeal Metastases of the Spine: A Systematic Review

et al. 2022

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“…Breast cancer is the most common malignancy which can cause LC followed by lung cancer 1. Cauda equina syndrome signs and symptoms include low back pain, unilateral or usually bilateral sciatica, saddle sensory disturbances, bladder and bowel dysfunction and variable lower extremity motor and sensory loss 2. Although the most common cause of cauda equina syndrome is compression, a diagnosis of LC should be considered in any patient with a history of cancer 3.…”

Section: Descriptionmentioning

confidence: 99%