[Leptomeningeal carcinomatous metastases]

The metastatic involvement of leptomeninges is an uncommon complication of systemic cancer, but there are evidences that its incidence is increasing, particularly for breast cancer. The two commonest primary sites are the breast and the lung and adenocarcinoma is the most frequent histologic type of carcinoma to metastasize to the leptomeninges. Clinical diagnosis is suggested by the simultaneous occurrence of symptoms and signs in more than one areas of CNS. Examination of cerebrospinal fluid is the most helpful diagnostic procedure. A combination of radiotherapy and intrathecal or intraventricular administration of Methotrexate seems to be the most successful treatment.