LC: clinical syndrome in different primaries

Area of Science:

• Neurology
• Oncology
• Pathology

Background:

• Leptomeningeal carcinomatosis (LC) is a rare but serious complication of various cancers, including breast, lung, melanoma, leukemia, and lymphoma.
• Clinical presentation of LC often poses diagnostic challenges due to overlapping symptoms with other neurological conditions.

Purpose of the Study:

• To provide a comprehensive overview of the clinical symptoms and signs associated with leptomeningeal carcinomatosis.
• To discuss the concept of multiple neuraxis lesions and their classification into central nervous system (CNS), spinal (SP), and cranial nerve (CN) involvement.
• To address the emergence of new symptoms and signs in patients undergoing antineoplastic chemotherapy and radiation therapy.

Main Methods:

• Review of own clinical results and extensive survey of existing literature on leptomeningeal carcinomatosis.
• Analysis of clinical manifestations, focusing on the prominence of signs over symptoms.
• Categorization of symptoms and signs based on neuraxis involvement (CNS, SP, CN).

Main Results:

• Leptomeningeal carcinomatosis commonly manifests as multiple neuraxis syndromes, affecting CNS, SP, and CN, often in combination.
• Clinical signs are generally more pronounced than subjective symptoms.
• New neurological deficits can arise during cancer treatment, complicating the clinical picture.

Conclusions:

• Accurate identification of LC symptoms and signs is critical for effective management.
• The study highlights the diverse clinical presentations of LC and the importance of considering neuraxis involvement.
• Further research is needed to optimize diagnostic and therapeutic strategies for leptomeningeal carcinomatosis.