[Diffuse metastatic leptomeningeal carcinomatosis (DMLC)]

Diffuse metastatic leptomeningeal carcinomatosis (DMLC) due to systemic cancer has been diagnosed clinically in 7 patients. The primary sites involved were the stomach, the lung, and the breast. In all patients, there was progressive clinical deterioration, the average survival after diagnosis being 18 weeks. Also, leptomeningeal metastases was found to be present in 7 or 47 (14.9%) patients with metastatic brain tumors at the National Kanazawa Hospital. The clinical diagnosis was confirmed by the presence of malignant cells in the cerebrospinal fluid, which showed a decrease in glucose and an increase in the protein content. Ommaya reservoirs were placed in two patients. Treatment consisted of intrathecal injections of either Methotrexate (MTX) alone or MTX and Cytosine arabinoside and venous injections of ACNU in combination with radiation therapy of the brain and the spine.