Leptomeningeal carcinomatosis is a manifestation in which tumor cells migrate into meninges. Breast carcinoma presenting with leptomeningeal metastases is a rare phenomenon that can occur in an isolated form as well as with coexistent parenchymal brain metastases. The gold standard for diagnosis is cerebrospinal fluid analysis, while contrast-enhanced magnetic resonance imaging is the most commonly used imaging modality. Nuclear medicine imaging with flourine-18-fluorodeoxyglucose positron emission tomography/computed tomography has proved to be useful in detecting leptomeningeal metastases and, at times, even before anatomical changes occur. Here, we present a case of breast carcinoma presenting with both pachymeningeal and leptomeningeal metastases 10 years after treatment.
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http://dx.doi.org/10.1055/s-0042-1757254 | DOI Listing |
Cancers (Basel)
January 2025
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94304, USA.
Background: Leptomeningeal disease (LMD) from cancer indicates advanced cancer and can lead to obstructive hydrocephalus, for which palliative cerebrospinal fluid (CSF) diversion may be indicated to alleviate symptoms. We investigated surgical outcomes for hydrocephalus for adult patients with LMD and conducted a systematic review on pediatric and adult cases.
Methods: We analyzed outcomes from a 10-year period of patients with neoplastic LMD, obstructive hydrocephalus, and documented date of death.
Clin Nucl Med
January 2025
From the Department of Nuclear Medicine, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
Neoplastic meningitis, also known as leptomeningeal metastases, is a rare clinical entity seen in less than 1%-2% of primary nervous system tumors. Diagnosis of leptomeningeal metastases is difficult and is achieved by cytologic evidence of malignant cells in cerebrospinal fluid, or demonstration of radiologic abnormality. 18F-FDG PET/CT can detect leptomeningeal metastases before anatomical changes.
View Article and Find Full Text PDFActa Neuropathol Commun
January 2025
Department of Neurosurgery, University of California, Los Angeles, CA, USA.
The incidence of brain metastases (BrM) in patients with metastatic melanoma is reported to be 30-50% and constitutes the third most frequent BrM after breast and renal cancers. Treatment strategies including surgical resection, stereotactic radiation, and immunotherapy have improved clinical response rates and overall survival, but the changes that occur in circulating melanoma cells to promote invasion of the brain are not fully understood. To investigate brain tropism, we generated new variants of the B16 mouse melanoma model by serially passaging B16 cells through the brain of immune competent syngeneic C57BL/6 mice.
View Article and Find Full Text PDFHeliyon
January 2025
School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Bevacizumab is widely used in various clinical indications, but investigations into its optimal dosage for treating CNS metastases remain limited. The BEEP regimen, comprising bevacizumab, etoposide, and cisplatin, has recently demonstrated promising clinical outcomes for patients with breast cancer brain metastasis (BCBM) or leptomeningeal metastasis (LM). This study aimed to evaluate the exposure-response relationship of bevacizumab in BCBM patients and to explore the improved CNS penetration of chemotherapy by bevacizumab with LM patients.
View Article and Find Full Text PDFCancer Treat Rev
January 2025
Division of Hematology and Oncology, University of Virginia Comprehensive Cancer Center, Charlottesville, VA, United States. Electronic address:
Background: Trastuzumab deruxtecan (T-DXd) has shown promising activity in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) and central nervous system (CNS) involvement. In this updated meta-analysis, we explore the effectiveness of T-DXd in a large subset of patients with HER2-positive BC and CNS disease.
Methods: A systematic search was made on September 16th, 2024, for studies investigating T-DXd in the scenario of HER2-positive BC and brain metastases (BMs) and/or leptomeningeal disease (LMD).
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