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Published on: May 19, 2020
Meningeal carcinomatosis: three case-reports
Guangyong Chen1, Long Ma1, Meiling Xu2
1Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China.
Background:
Meningeal carcinomatosis (MC) is characterized by diffuse infiltration of tumor cells in meninges. There is no tumor mass in the brain and parenchyma of the spinal cord. MC is divided into primary and metastatic types. MC cases were previously diagnosed postoperatively or at autopsy. Recent advances in spinal abbreviation cytology and imaging have led to increase in number of reported cases. In this study, we discuss the manifestations of MC patients based on magnetic resonance imaging (MRI) findings, as well as the correlation between the manifestations and pathology.
Case Presentation:
MC was confirmed in all three cases by lumbar puncture and gadopentetate dimeglumine-enhanced magnetic resonance imaging. Due to different primary diseases, the patients had specific imaging manifestations.
Conclusion:
Enhanced MRI examination is extremely sensitive for detecting abnormalities in meninges, which plays a very important role in the diagnosis of MC. Since meninges of some MC patients cannot be enhanced, the enhanced MRI examination cannot be replaced by conventional cerebrospinal abbreviation examination. Attribute to the diversity of MR contrast agents, which could provide higher lesion conspicuity and enhances lesion detection, there may be some more choices to improve the detection rate of MC patients and prolong their survival lifetime.
Insights
Meningeal carcinomatosis (MC) diagnosis is improved with enhanced MRI, offering better detection and potentially longer survival. This imaging technique is crucial for identifying meningeal abnormalities.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Meningeal carcinomatosis (MC) involves diffuse tumor cell infiltration of the meninges without brain or spinal cord parenchymal mass.
- MC can be primary or metastatic, with diagnosis historically relying on post-operative or autopsy findings.
- Advances in imaging and cytology have increased MC case reporting.
Observation:
- Three MC cases were confirmed using lumbar puncture and gadolinium-enhanced magnetic resonance imaging (MRI).
- Patients presented with distinct imaging manifestations attributed to their diverse primary diseases.
- Enhanced MRI is highly sensitive for detecting meningeal abnormalities in MC.
Findings:
- Enhanced MRI plays a critical role in diagnosing meningeal carcinomatosis.
- Conventional cerebrospinal fluid examinations are insufficient as some MC meninges do not enhance.
- Diverse MR contrast agents can improve lesion conspicuity and detection rates.
Implications:
- Enhanced MRI significantly aids in the diagnosis of meningeal carcinomatosis.
- Improved detection rates through advanced contrast agents may enhance patient outcomes.
- Further research into MR contrast agents could improve MC detection and patient survival.
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