The Clinical Features of Spinal Leptomeningeal Dissemination from Malignant Gliomas.

Bae, Jung Sik; Yang, Seung Ho; Yoon, Woan Soo; Kang, Seok Gu; Hong, Yong Kil; Jeun, Sin Soo

doi:2011.49.6.334

Original Article

Journal of Korean Neurosurgical Society 2011;49(6): 334-338.
doi: https://doi.org/10.3340/jkns.2011.49.6.334

The Clinical Features of Spinal Leptomeningeal Dissemination from Malignant Gliomas.

Jung Sik Bae, Seung Ho Yang, Woan Soo Yoon, Seok Gu Kang, Yong Kil Hong, Sin Soo Jeun

¹Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. ssjeun@catholic.ac.kr
²Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea.
³Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.

ABSTRACT

OBJECTIVE
The incidence of leptomeningeal dissemination from malignant glioma is rare, so the clinical features of this are not well documented yet. We attempted to determine the clinical features of leptomeningeal dissemination from malignant gliomas.
METHODS
We retrospectively analyzed 11 cases of leptomeningeal dissemination of malignant glioma, who were treated at our institution between 2006 and 2009. We investigated the clinical features of these patients by considering the following factors : tumor locations, the events of ventricular opening during surgery and the cerebrospinal fluid (CSF) profiles, including the cytology.
RESULTS
The group was composed of 9 males and 2 females. The histological diagnosis of their initial intracranial tumors were 4 primary glioblastoma, 3 anaplastic astrocytoma, 1 anaplastic oligoastrocytoma, 2 ganglioglioma and 1 pleomorphic xanthoastrocyotma with anaplastic features. The mean age of the patients at the time of the initial presentation was 42.8+/-10.3 years. The mean time between surgery and the diagnosis of spinal dissemination was 12.3+/-7.9 (3-28) months. The mean overall survival after dissemination was 2.7+/-1.3 months. All our patients revealed a history of surgical opening of the ventricles. Elevated protein in the CSF was reported for eight patients who had their CSF profiles checked.
CONCLUSION
We propose that in the malignant gliomas, the surgical opening of ventricles can cause the spinal leptomeningeal dissemination and the elevated protein content of CSF may be a candidate marker of leptomeningeal dissemination.

Key Words: Seeding; Malignant glioma; Spinal dissemination