Meningeal carcinomatosis: treatment with intrathecal methotrexate

A case of bronchogenic carcinoma with meningeal carcinomatosis is reported. Intrathecal chemotherapy with twice weekly methotrexate was effective in clearing the cerebrospinal fluid abnormalities, pathologic evidence of meningeal disease, and all of the clinical manifestations, with the exception of spinal root symptoms and signs associated with tumor infiltration of nerve roots at autopsy. The role of radiotherapy as an adjunct to chemotherapy in the treatment of this condition is discussed.