Carcinomatous meningitis results from the spread of cancer cells into the leptomeninges, the subarachnoid space surrounding the brain and spinal cord. It typically occurs from metastasis of neoplastic cells from a primary tumor site, mostly commonly breast or lung cancer or melanoma, and occurs in 5% of patients with these cancers. Carcinomatous meningitis can also occur after seeding of the subarachnoid space from a primary brain tumor such as a medulloblastoma. Rarely, primary diffuse meningeal melanomatosis can occur.
Symptoms include headache, neck or back pain, altered mental status, seizures, weakness, and sensory disturbances. Fever is typically absent. Multiple cranial neuropathies, particularly in a patient with a known cancer diagnosis, should raise concerns for this condition. Prognosis is poor, and median survival with treatment is less than 6 months.
Emergency: requires immediate attention
Carcinomatous meningitis
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Synopsis
Codes
ICD10CM:
C70.1 – Malignant neoplasm of spinal meninges
SNOMEDCT:
230156002 – Malignant meningitis
C70.1 – Malignant neoplasm of spinal meninges
SNOMEDCT:
230156002 – Malignant meningitis
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Last Reviewed:03/15/2018
Last Updated:05/31/2023
Last Updated:05/31/2023