[Clinical studies of meningeal gliomatosis]

Abstract

Ten (23%) patients out of 43 with malignant glioma developed meningeal gliomatosis during the follow up period of at least one year. The duration between the first surgery and diagnosis of meningeal gliomatosis ranged from one to 78 weeks (median 45 weeks). In younger age group less than 20 years old, 5 (56%) out of 9 patients had meningeal gliomatosis, and on the contrary the incidence was lower in older age group above 20 years old (5 of 34, 15%). Seven (22%) out of 32 male and 3 (27%) out of 11 female patients developed meningeal gliomatosis. The primary tumor location were frontal lobe in 4 cases (including one bifrontal tumor), temporal in 2, parieto-occipital in 1, thalamus in 1, midbrain in 1, and cerebellar hemisphere in 1, respectively. Histologically, 7 tumors were anaplastic astrocytoma, and 3 were glioblastoma. The characteristic neurological findings observed during the course of meningeal gliomatosis were abnormal mental status (80%), cranial nerve palsies (50%), paraplegia (60%), stiff neck (80%), seizure (50%), and respiratory disturbance (80%), CSF cytology was positive in all 9 patients tested. CT scan demonstrated hydrocephalus (70%), and diffuse contrast enhancement of ventricular wall (60%) and basal cistern (10%). In 2 cases, block and irregular filling defect were seen by myelography. Six patients were treated by irradiation to the whole brain and/or spine, and 5, by intrathecal chemotherapy with methotrexate, cytosine arabinoside and bleomycin. However, all patients died of the tumor one to 46 weeks (median 18 weeks) after the diagnosis of meningeal gliomatosis.(ABSTRACT TRUNCATED AT 250 WORDS)