Meningeosis neoplastica is the spread of tumor cells in the area of the meninges. It is treated surgically or with chemotherapy and radiation. The earlier meningeosis neoplastica is detected, the better the prognosis for those affected. Nevertheless, the overall prognosis is poor because there is usually an additional primary cancer.
Meningeosis neoplastica is the spread of tumor cells in the soft meninges. They play an important role in metabolism and surround the brain. They protect the brain from external influences such as temperature fluctuations.
The meninges merge into the spinal meninges and are connected to the cerebrospinal fluid. In this way, tumor cells also enter the meninges, as meningeosis neoplastica usually occurs due to an existing cancer. Existing tumor cells enter the entire body via the blood or lymph and thus reach the meninges.
The meninges surround the brain in several layers within the skull @ bilderzwerg / AdobeStock
Around 3-5 % of cancer patients develop meningeosis neoplastica. The names differ depending on where the cancer cells originate:
However, the origin of the tumor cells has no influence on the symptoms or the course of the disease.
The symptoms of meningeosis neoplastica depend on both the extent of the disease and its localization:
Due to the increased intracranial pressure and possible damage to the spinal cord, some patients experience the following symptoms:
In the early stages, meningeosis neoplastica is often asymptomatic. The first slight signs of metastasis are usually not taken seriously or correctly classified.
The first examination for suspected meningeosis neoplastica is an MRI of the skull and spine in the neuroradiology department. If possible, a contrast agent is used, as the brain structures cannot be clearly seen otherwise. The MRI images show the spread of the tumor disease and exactly which structures are affected. If an MRI cannot be carried out, doctors resort to a CT scan.
If the MRI findings are conspicuous, a cerebrospinal fluid puncture is performed to confirm the diagnosis. Specialists remove spinal fluid from the lumbar spine and then examine it for existing tumor cells.
If the initial findings are negative, up to two further tests are useful. If the doctors are still unable to detect any cancer cells, a biopsy can provide further information.
Treating meningeosis neoplastica is a challenge. The procedure depends on the exact spread of the cancer cells. If metastases are also present in other parts of the body, systemic chemotherapy is used.
As most drugs do not cross the blood-brain barrier, they usually have no positive effect on meningeosis neoplastica. The blood-brain barrier describes the border between the blood and the central nervous system. Only certain substances can pass through the cells on the outside of the vessel wall into the brain. This protects the brain from harmful substances, pathogens and toxins.
As drugs are not effective, intrathecal chemotherapy is used to combat tumor cells in the meninges. The active substances are injected either via a lumbar puncture or via a channel directly into the cerebrospinal fluid. This therapy has fewer side effects as the dose used is usually low.
If possible, larger brain and spinal cord tumors are surgically removed followed by chemotherapy and/or radiation.
In order to effectively treat several smaller tumors in the brain and on the meninges, the affected areas are irradiated. Patients also receive radiation in palliative therapy to alleviate pain.
When treating meningeosis neoplastica, doctors and patients always weigh up the costs and benefits of the procedure. The prognosis is rather poor, with a 1-year survival rate of 5-25%. Even if the cancer cells in the brain are successfully treated, other tumors in the body can weaken the patient too much. And ultimately lead to death. With a good prognosis, the average survival time is around seven months.
As a cancer, meningeosis neoplastica falls under the specialist field of oncology. Most of those affected are already under oncological care due to the primary tumor that caused the disease. You should always discuss any new symptoms with your oncologist in order to detect metastases at an early stage.
Specialists usually consult a neurologist for diagnosis and treatment. They are very familiar with the structures in the brain and its metabolism. In close cooperation with the treating oncologist, he or she coordinates the treatment of meningeosis neoplastica and monitors its progress.
Imaging diagnostics using CT and radiotherapy are carried out by a neuroradiologist. He specializes in the radiotherapy of brain tissue. He is therefore also an expert in the structures of this organ. At the same time, they know the correct radiation dosages and can carry out the therapy based on the imaging.
The greatest risk factor for the occurrence of meningeosis neoplastica is the presence of another cancer. If metastases form in the meninges, the time factor plays a major role: the earlier doctors find metastases in the meninges, the sooner they can be treated.
However, even if specialists are able to bring meningeosis neoplastica under control, the prognosis is still poor due to the primary cancer.
https://www.aerzteblatt.de/archiv/52868/Meningeosis-neoplastica
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