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Summary
Malignant cells spread to the cerebrospinal leptomeninges via perineural, endoneural, and perivascular lymphatics. This anatomopathologic study suggests local therapy may effectively palliate meningeal carcinomatosis.
Area of Science:
- Neuropathology
- Oncology
- Anatomopathology
Background:
- Meningeal carcinomatosis (MC) is a rare complication of cancer.
- Understanding tumor spread routes is crucial for effective treatment.
Purpose of the Study:
- To investigate the routes of tumor spread in pure meningeal carcinomatosis.
- To examine the role of choroid plexuses in MC.
Main Methods:
- Anatomopathologic examination of 18 cases of pure MC.
- Microscopic analysis of the brain, spinal cord, and associated structures in 5 cases.
Main Results:
- Malignant cells likely spread via perineural, endoneural, and perivascular lymphatics through foramina.
- Choroid plexus involvement appears secondary, with tumor cells reaching via perivascular sheaths.
- MC was the sole metastatic manifestation beyond regional lymph nodes in 40% of cases.
Conclusions:
- Perineural, endoneural, and perivascular lymphatics are key routes for MC.
- Local therapy targeting the cerebrospinal leptomeninges may offer effective palliation.