Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Emergency: requires immediate attention
Carcinomatous meningitis
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Carcinomatous meningitis

Contributors: Andrea Wasilewski MD, Jamie Adams MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Carcinomatous meningitis results from the spread of cancer cells into the leptomeninges, the subarachnoid space surrounding the brain and spinal cord. It typically occurs from metastasis of neoplastic cells from a primary tumor site, mostly commonly breast or lung cancer or melanoma, and occurs in 5% of patients with these cancers. Carcinomatous meningitis can also occur after seeding of the subarachnoid space from a primary brain tumor such as a medulloblastoma. Rarely, primary diffuse meningeal melanomatosis can occur.

Symptoms include headache, neck or back pain, altered mental status, seizures, weakness, and sensory disturbances. Fever is typically absent. Multiple cranial neuropathies, particularly in a patient with a known cancer diagnosis, should raise concerns for this condition. Prognosis is poor, and median survival with treatment is less than 6 months.

Codes

ICD10CM:
C70.1 – Malignant neoplasm of spinal meninges

SNOMEDCT:
230156002 – Malignant meningitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Infectious meningitis (Aseptic meningitis, Bacterial meningitis, Fungal meningitis)
  • Multifocal motor neuropathy with conduction block
  • Motor neuron disease
  • Lyme disease
  • Tertiary syphilis
  • West Nile virus
  • Vasculitis
  • Subarachnoid hemorrhage
  • Aseptic meningitis

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:03/15/2018
Last Updated:05/31/2023
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Emergency: requires immediate attention
Carcinomatous meningitis
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A medical illustration showing key findings of Carcinomatous meningitis : Headache, Nausea/vomiting, Ataxia, Delirium, Mental status alteration, Focal neurologic deficit
Copyright © 2024 VisualDx®. All rights reserved.