Leptomeningeal metastasis is a neurological emergency where cancer spreads to the meninges and subarachnoid spaces. It occurs in 3-8% of cancer patients and is seen most often in breast cancer, lung cancer, and melanoma patients. Clinical presentation includes symptoms like headache, altered mental status, nausea, seizures, and neurological deficits. Treatment involves surgery, chemotherapy, and radiotherapy, though prognosis is generally poor if left untreated, with hematological cancers having a better outlook than solid tumors.

1. Leptomeningeal Metastasis
A brief overview
Ade Wijaya, MD – April 2021

2. Layout:
• Introduction
• Epidemiologty
• Pathopysiology
• Clinical presentation
• Treatment
• Prognosis

3. Introduction
• Emergency in neurooncology
• Increase incidence due to increase life
expectancy in cancer patients
• Spreading of tumor into meningens and
subarachnoid spaces

4. Epidemiology
• 3-8 % of cancer
• Solid tumor: breast (12-35%), lung (10-26%),
melanoma (5-25%)
• Hematological malignancy

5. Patophysiology
• Hematogenic
• Direct spreading
• Perineural migration
• Iatrogenic

6. Clinical Presentation
• Hydrocephalus
• Cranial nerve palsy
• Brain edema
• Headache
• Altered mental status
• Nausea and vomitus
• Seizures
• Focal neurological deficits
• Gait disorder
• Pain
• Weakness
• Etc

7. Diagnosis
• Imaging
• CSF analysis
• Biopsy

8. Treatment
• Surgical
• Chemotherapy
• Radiotherapy

9. Prognosis
• Poor prognosis if left untreated
• Hematological malignancy has better
prognosis than the solid one
• Among the solid tumor, breast cancer has the
best prognosis

10. THANK YOU