Response of Leptomeningeal Dissemination of Anaplastic Glioma to Temozolomide: Experience of Two Cases.
10.14791/btrt.2017.5.2.99
- Author:
Jin Woo BAE
1
;
Eun Kyung HONG
;
Ho Shin GWAK
Author Information
1. Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Leptomeningeal carcinomatosis;
Temozolomide;
Drug effect;
Cerebrospinal fluid;
Malignant glioma
- MeSH:
Brain;
Cerebrospinal Fluid;
Craniospinal Irradiation;
Diagnosis;
Drug Therapy;
Glioma*;
Humans;
Incidence;
Meningeal Carcinomatosis;
Methotrexate;
Recurrence
- From:Brain Tumor Research and Treatment
2017;5(2):99-104
- CountryRepublic of Korea
- Language:English
-
Abstract:
The incidence of leptomeningeal dissemination (LMD) of anaplastic glioma has been increasing. LMD can be observed at the time of initial presentation or the time of recurrence. As a result of both rarity and unusual presentation, a standard therapy has not yet been suggested. In contrast to leptomeningeal carcinomatosis for systemic solid cancers, a relatively prolonged survival is observed in some patients with LMD of anaplastic gliomas. Treatment modalities include whole craniospinal irradiation, intra-cerebrospinal fluid (CSF) chemotherapy, and systemic chemotherapy. In some cases, response to temozolomide (TMZ), with or without combined radiation has been reported. Here, we report two cases of LMD of an anaplastic glioma. In one case LMD presented at the time of diagnosis, and in the other at the time of recurrence after radiation. CSF cytology was positive in both cases, and persisted in spite of intrathecal methotrexate chemotherapy. Later, TMZ was prescribed for progressing brain parenchymal lesions, and both radiological and cytological responses were obtained after oral TMZ treatment.
