Leptomeningeal Metastases

What are Leptomeningeal Metastases?

Leptomeningeal Metastases (LM) are a rare, but serious complication of cancer that occurs when the cancer has spread to the leptomeninges, the thin layer of tissue that covers the brain and spinal cord. It is a terminal condition, and there is no known cure.

LM can be caused by any type of primary cancer, but those most commonly associated with LM are lung cancer, breast cancer, glioblastoma, and melanoma.

Signs and Symptoms of Leptomeningeal Metastases

The symptoms of LM vary depending on the location and size of the tumors. Some common symptoms include:

Headaches
Seizures
Muscle Weakness
Numbness and Tingling
Cognitive Changes
Incoordination
Vision Loss
Hearing Loss
Nausea and Vomiting
Fatigue

Diagnosis of Leptomeningeal Metastases

The diagnosis of LM is complicated and requires a combination of imaging studies, fluid analysis, and biopsy. These tests can include:

CT or MRI scans of the brain or spine
Lumbar puncture to collect and analyze CSF for signs of cancer cells
Biopsy of the leptomeninges to confirm the diagnosis

Treatment of Leptomeningeal Metastases

Treatment of LM is supportive in nature and focuses on controlling symptoms and prolonging life. Treatment may include:

Corticosteroids to reduce inflammation
Anticonvulsants to prevent and control seizures
Radiation therapy
Chemotherapy
Pain medications

Prognosis of Leptomeningeal Metastases

LM is a terminal condition and the prognosis is generally poor. Most patients with LM have a life expectancy of less than 6 months.