Meningeal Carcinomatosis and Uterine Carcinoma: Three Different Clinical Settings and Review of the Literature

Asensio, N.; Luís, A.; Costa, Isabel; Oliveira, J.; Vaz, Fátima

doi:10.1111/igc.0b013e31819a1e1a

Cited by 18 publications

(17 citation statements)

References 26 publications

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“…Similar results were obtained by Quijano et al [19]. In their work analyzing the sensitivity of an 11 such as human chorionic gonadotropin, B 2 -microglobulin, lactic dehydrogenase, α-fetoprotein, and others have had limited success due to overall low sensitivity [20]. More specific markers related to the underlying biology of the metastatic process are being evaluated as a means of identifying the presence of malignancy in the CSF, as well as to potentially serve as markers of disease burden [21].…”

Section: Diagnosissupporting

confidence: 87%

“…As such, the incidence of NM in diseases that were previously not associated with CNS spread (including NM) is likely to rise. For example, cases of NM resultant from primary malignancies such as hormone refractory prostate cancers [5•, 6], ovarian cancers [7][8][9], cervical and endometrial cancers [10,11], and gastric cancers [12][13][14][15] that were previously rarely associated with NM appear to be increasing.…”

Section: Introductionmentioning

confidence: 99%

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Biology and Therapy of Neoplastic Meningitis

Mammoser

Groves

2010

Curr Oncol Rep

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Neoplastic meningitis (NM) occurs in 5% to 8% of cancer patients, commonly as an end-stage process in previously metastatic disease. As newer therapeutics extend patient survival by maintaining long-term control of systemic malignancies, the incidence of NM is likely to rise. This can be expected both because of a change in the natural history of the underlying disease and the generally poor penetrance of many newer anticancer drugs into the central nervous system, thereby creating a sanctuary site for malignant cells. Currently available treatments have provided limited benefit in overall survival in NM, although long-term survival does occur. Because of the morbidity occasionally associated with treatment, prognostic indicators are being analyzed to identify patients who may benefit from systemic and/or intrathecal therapy before making the decision to initiate treatment. Additionally, because of the relative insensitivity of traditional cerebrospinal fluid analysis, new markers of NM are being investigated. This endeavor is being aided by ongoing research into the underlying biology of the metastatic process.

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Section: Diagnosissupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Biology and Therapy of Neoplastic Meningitis

Mammoser

Groves

2010

Curr Oncol Rep

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“…Tumors that are known to frequently cause meningeal carcinomatosis include breast cancer, small-cell lung cancer, hematologic malignancies, and malignant melanoma, but meningeal carcinomatosis arising from gynecologic malignancies is considered to be very rare [8,10]. In particular, reports of meningeal carcinomatosis arising from uterine cervical cancer are extremely limited, and our search found only 13 cases in the English literature (Table 1) [10][11][12][13][14][15][16][17][18][19][20][21]. In those previous reports, diagnosis of meningeal carcinomatosis arising from cervical cancer was not confirmed at autopsy, so our case is the first to have such documentation.…”

Section: Discussionmentioning

confidence: 99%

“…Although there are no abnormalities of the brain parenchyma, there is marked enhancement around the lateral ventricles (arrows) However, the response to such measures is limited and they only have a palliative effect [22,23]. Although meningeal carcinomatosis is usually diagnosed by detecting malignant cells in the cerebrospinal fluid at lumbar puncture, use of noninvasive magnetic resonance imaging (MRI) has also been recommended recently [10,22]. By careful examination of the head CT findings, we were able to diagnose meningeal carcinomatosis without any accumulation of cerebrospinal fluid.…”

Section: Discussionmentioning

confidence: 99%

A case of primary uterine cervical neuroendocrine tumor with meningeal carcinomatosis confirmed by diagnostic imaging and autopsy

et al. 2010

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Primary uterine cervical neuroendocrine tumors are rare, but affect relatively young women and the prognosis is poor despite multidisciplinary treatment. The incidence of meningeal carcinomatosis arising from malignant tumors of the uterine cervix is extremely low, only two patients with meningeal carcinomatosis arising from a uterine cervical neuroendocrine tumor have been reported in the English literature. Moreover, there have been no reports in which this was confirmed at autopsy. We encountered a pregnant woman aged 33 years who was diagnosed as having atypical carcinoid of the uterine cervix after radical surgery. Despite multidrug chemotherapy (paclitaxel + etoposide + cisplatin and irinotecan + carboplatin), the patient developed multiple organ metastases. Although there was no metastasis to the brain parenchyma or the spinal cord parenchyma, the patient also developed meningeal carcinomatosis. Whole-brain radiation therapy was performed, but was ineffective. The patient died at 19 months after her initial operation and 10 days after diagnosis of meningeal carcinomatosis. The presence of meningeal carcinomatosis was confirmed at autopsy.

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“…LM caused by gynecologic malignancies is commonly associated with ovarian cancer; the most frequent pathological finding is undifferentiated or poorly differentiated carcinomas of the serous histological subtype [11,55]. The incidence of LM increases with effective tumor treatment local control of the tumor site; this allows for more time to develop LM.…”

Section: Prevalencementioning

confidence: 99%

Epilepsy in women with gynecologic malignancies

Yang

Wang

2014

Expert Review of Neurotherapeutics

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Women with gynecologic malignancies are a population with various risk factors for epilepsy. Gynecologic malignancies can substantially affect daily life, even if the tumor is well controlled. Gynecologic malignancies may cause brain metastasis, paraneoplastic neurological disorders, or leptomeningeal carcinomatosis, which potentially directly cause seizures and epilepsy. Moreover, metabolic disorders, central nervous system infections, cerebrovascular complications, and chemotherapeutic drugs can indirectly induce ictus. Radiotherapy of brain metastases can also lead to seizure and epilepsy. Understanding these pathogenic mechanisms may provide novel viewpoints or methods for diagnosis, prevention and treatment of epilepsy associated with gynecologic malignancies. In this article, we extensively review the related literature regarding potential aetiologies, their mechanisms, clinical features, diagnosis and treatment.

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Meningeal Carcinomatosis and Uterine Carcinoma: Three Different Clinical Settings and Review of the Literature

Abstract: A high index of suspicion is necessary, and leptomeningeal carcinomatosis should be considered in patients with unexplained neurologic symptoms whose gynecologic tumors are poorly undifferentiated or have a serous component.

Cited by 18 publications

References 26 publications

Biology and Therapy of Neoplastic Meningitis

Biology and Therapy of Neoplastic Meningitis

A case of primary uterine cervical neuroendocrine tumor with meningeal carcinomatosis confirmed by diagnostic imaging and autopsy

Epilepsy in women with gynecologic malignancies

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