gms | German Medical Science

Objective: Meningeosis neoplastica is a rare manifestation of high-grade gliomas and is usually associated with devastating outcome. The aim of this study was to investigate rate, clinical manifestation and outcome of this disease using a large single-center brain tumor registry basis.

Methods: We reviewed data of 481 patients, who were treated for high-grade glioma (WHO grade III or IV) at our institution between 2006 and 2018. Patient and tumor characteristics, operative and adjuvant therapies, as well as progression free survival and overall survival were recorded. The diagnosis of meningeosis neoplastica was based either on leptomeningeal and/or spinal tumor manifestation on MRI imaging or positive samples of cerebrospinal fluid.

Results: Meningeosis neoplastica was found in 11 patients (2.2%). 4 patients developed spinal metastases and 7 patients suffered from a leptomenigeal manifestation. Mean age of the patients at tumor diagnosis was 50 years. The most frequent diagnostic tool was MRI (9 patients) followed by positive sample of cerebrospinal fluid in in two cases. Typical symptoms were headache, nausea, vomiting, acute paraparesis. Hydrocephalus symptoms were seen in 6 patients (54%). Mean overall survival was 41 months and mean progression free survival was 22 months. Meningeosis neoplastica developed 37 months after the first diagnosis of glioma. The time between the meningeosis manifestation and death was 2 months. Two patients underwent salvage spinal radiation therapy. 6 patients (54,5%) developed hydrocephalus and 5 of them received ventriculoperitoneal shunt and 1 patient received external ventricular drainage.

Conclusion: Meningeosis neopastica was found in less than 3% of patients with high-grade gliomas in a large single-center brain tumor registry. The prognosis is extremely poor, the overall survival after the manifestation of meningeosis was no longer than 2 month. Salvage therapies did not improve the outcome.