Disease Information for Meningeal carcinomatosis

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Clinical Manifestations
Signs & Symptoms
Neck muscle pains
Numbness of face
Distal leg weakness
Distal Muscle Weakness
Proximal upper extremity weakness
Altered mental status Mental status change
CNS symptoms/signs
Cognitive defect
Confusion/Disoriented
Delirium
Delirium/Agitated delirium
Drowsiness/somnolence
Facial Nerve Palsy/Facial Paralysis
Facial weakness/droop, unilateral
Focal neurologic deficit
Headache
Headache worse lying down
Impaired judgement/signs
Kernigs sign
Meningeal Signs
Neurological symptoms/signs
Nystagmus
Papilledema on exam
Seizures
Stiff neck/Nuchal rigidity
Stupor/poor reponse to stimulus
Sudden unconsciousness
Neck pain
Anosmia/Loss of sense of smell
Hypersomnia/Increased need for sleep
Malaise
Blurred Optic Disk Margin
Difficulty Focusing Eyes
Diplopia Double vision
Lateral gaze weakness
Retinal fundus congested/edematous (eye)/sign
Visual symptoms
True Vertigo Sign Confirmed
Disease Progression
Course/Chronic disorder
Course/Chronic only
Laboratory Tests
Abnormal Lab Findings (Non Measured)
CSF abnormal
CSF Cytology Abnormal
CSF Large cells present
CSF Tumor-like cells present
Abnormal Lab Findings - Decreased
CSF Cells
CSF Glucose
Abnormal Lab Findings - Increased
CSF Cells
CSF LDH
CSF Leukocytes
Microlab/CSF Culture negative
Diagnostic Test Results
Other Tests & Procedures
Lumbar puncture/abnormal
Lumbar puncture/Increased CSF pressure/LP test
Pathology
Cytology/CSF/Abnormal
PATH/Brain Focal Degeneration/Lesion
PATH/Brain/Leptomeningeal Lesions
CT Scan
CT Scan/Head Meningeal enhancement/hyperdense
MRI/Head Brain Abnormal
MRI/Head Contrast enhanced cortex convexities
MRI/Head Contrast enhanced/basilar cisterns/Brain
MRI/Head Dilated ventricles
MRI/Head Meningeal enhancement/Meningitis
MRI/Spinal cord abnormalities
Associated Diseases & Rule outs
Rule Outs
Alzheimers disease
Cavernous sinus thrombosis
Craniopharyngioma
Encephalitis, viral
Leukemic meningitis
Meningitis Bacterial
Meningitis, chronic
Meningitis, viral
Associated Disease & Complications
Aseptic meningitis syndrome
Bells palsy/Facial nerve paralysis
CNS disease/involvement
Convulsions (grand mal)
Facial nerve palsy/secondary
Herpes zoster
Hydrocephalus
Hydrocephalus, acute acquired
Hydrocephalus, chronic acquired
Inappropriate ADH secretion syndrome
Increased CNS pressure/Intracranial hypertension
Meningeal metastasis/secondary neoplasm
Meningitis, chronic
Facial Paralysis
Disease Mechanism & Classification
Class
CLASS/Meninges/pia/arachnoid involvement (ex)
CLASS/Neurologic (category)
Pathophysiology
Pathophysiology/CSF Pressure Increased
Pathophysiology/Extramedullary Spinal Tumor
Process
PROCESS/Calcifying neoplasm/malignancy (ex)
PROCESS/Carcinoma (ex)
PROCESS/Complicating disorder (ex)
PROCESS/Complicating/Specific process disorder (ex)
PROCESS/Inflammatory/Granulomatous disorder (category)
PROCESS/Malignancy/cancer (ex)
PROCESS/Metastatic cancer disorder (ex)
PROCESS/Neoplastic (category)
Treatment
Drug Therapy - Indication
RX/Intrathecal methotrexate
Other Treatments
TX/Brain radiation.
Definition

Tumor cells that have spread from the original (primary) tumor to the tissue that covers the brain, spinal cord, or both -----------------------------------------------------The neoplasms metastasizing most commonly to the leptomeninges are carcinoma of the breast, lymphomas, and leukemia; Leptomeningeal metastases lead to multifocal neurologic deficits, which may be associated with infiltration of cranial and spinal nerve roots, direct invasion of the brain or spinal cord, obstructive hydrocephalus, or some combination of these factors; The diagnosis is confirmed by examination of the cerebrospinal fluid; Findings may include elevated cerebrospinal fluid pressure, pleocytosis, increased protein concentration, and decreased glucose concentration; Cytologic studies may indicate that malignant cells are present; if not, spinal tap should be repeated at least twice to obtain further samples for analysis; CT scans showing contrast enhancement in the basal cisterns or showing hydrocephalus without any evidence of a mass lesion support the diagnosis; Gadolinium-enhanced MRI frequently shows enhancing foci in the leptomeninges; Myelography may show deposits on multiple nerve roots; Treatment is by irradiation to symptomatic areas, combined with intrathecal methotrexate; The long-term prognosis is poor—only about 10% of patients survive for 1 year—and palliative care is therefore important (End of Life Care)-----[CMDT 2005]-----------

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External Links Related to Meningeal carcinomatosis
Google
Wikipedia
Merck
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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