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Updated: Jul 29, 2026
Induction of Leptomeningeal Cells Modification Via Intracisternal Injection
Published on: May 7, 2020
Radiation-induced glioma presenting as diffuse leptomeningeal gliomatosis: a case report
M D Hill1, I Mackenzie, W P Mason
1Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada.
Background:
Leptomeningeal gliomatosis is a rare and fatal disease.
Methods:
Case report.
Results:
We report the case of a man who was presented with severe intractable headaches, lymphocytic CSF pleocytosis, and spinal leptomeningeal enhancement on contrast MRI. Meningeal biopsy demonstrated diffuse infiltration by malignant glial cells, and symptom alleviation was achieved by CSF diversion. He later developed an enhancing thalamic tumor arising within the treatment field of a remotely irradiated pituitary adenoma. Subsequent management included chemotherapy and further radiotherapy with transient response, before death from leptomeningeal and parenchymal tumor progression 16 months after diagnosis.
Conclusion:
We report a unique case embodying two rare conditions: radiation induced glioma and leptomeningeal gliomatosis. Our patient's course is novel in that symptomatic relief was achieved with CSF diversion and a combination of chemotherapy and focal radiation allowed prolonged survival.
Insights
This case report details a rare instance of leptomeningeal gliomatosis and radiation-induced glioma. Symptomatic relief was achieved through CSF diversion, and treatment prolonged survival.
Area of Science:
- Neuro-oncology
- Neuropathology
Background:
- Leptomeningeal gliomatosis is a rare, aggressive, and often fatal central nervous system disease.
- This report focuses on a unique case combining leptomeningeal gliomatosis with radiation-induced glioma.
Observation:
- A patient presented with severe headaches, lymphocytic cerebrospinal fluid (CSF) pleocytosis, and leptomeningeal enhancement on MRI.
- Meningeal biopsy confirmed diffuse infiltration by malignant glial cells.
- A secondary thalamic tumor developed within a previously irradiated field for a pituitary adenoma.
Findings:
- CSF diversion provided symptomatic relief for leptomeningeal gliomatosis.
- Combined chemotherapy and focal radiotherapy resulted in a transient response.
- The patient ultimately succumbed to leptomeningeal and parenchymal tumor progression 16 months post-diagnosis.
Implications:
- This case highlights the potential for radiation-induced gliomas in patients with a history of radiotherapy.
- The findings suggest that CSF diversion can be a valuable palliative measure for leptomeningeal gliomatosis.
- The combination of therapies demonstrated potential for prolonged survival in complex CNS tumor cases.
