Neoplastic meningitis as the presentation of occult primitive neuroectodermal tumors Journal Article


Authors: Jennings, M. T.; Slatkin, N.; D'Angelo, M.; Ketonen, L.; Johnson, M. D.; Rosenblum, M.; Creasy, J.; Tulipan, N.; Walker, R.
Article Title: Neoplastic meningitis as the presentation of occult primitive neuroectodermal tumors
Abstract: Seven children and young adults initially presented with subacute meningitis and/or increased intracranial pressure. The diagnosis of neoplastic meningitis secondary to a primitive neuroectodermal neoplasm was delayed by the absence of an obvious primary tumor. The neuroradiologic appearance was that of a basimeningeal infiltrative process, complicated by communicating hydrocephalus or ''pseudotumor cerebri.'' Myelography was important in the diagnosis of disseminated meningeal malignancy in four cases. Cerebrospinal fluid cytologic diagnosis was insensitive but ultimately confirmed in five cases. All seven patients experienced progressive disease despite neuraxis radiotherapy and intensive chemotherapy; six have died. Systemic dissemination to bone and/or peritoneum occurred in three patients while on therapy. In two, a primary parenchymal brain or spinal cord tumor could not be identified at postmortem examination. The presentation of a primitive neuroectodermal tumor as subacute meningitis without an evident primary tumor heralds an aggressive and refractory neoplasm.
Keywords: medulloblastoma; childhood; glioblastoma-multiforme; spinal metastases; pilocytic astrocytoma; cerebrospinal-fluid; leptomeningeal dissemination; brain-stem; supratentorial malignant gliomas; meningeal gliomatosis
Journal Title: Journal of Child Neurology
Volume: 8
Issue: 4
ISSN: 0883-0738
Publisher: Sage Publications, Inc.  
Date Published: 1993-10-01
Start Page: 306
End Page: 312
Language: English
ACCESSION: WOS:A1993MA26000003
DOI: 10.1177/088307389300800403
PROVIDER: wos
PUBMED: 8228025
Notes: Article -- Source: Wos
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  1. Marc Rosenblum
    424 Rosenblum
  2. Russell W. Walker
    38 Walker