Leptomeningeal metastases from genitourinary cancer: The University of Texas MD Anderson Cancer Center experience

Abstract

Leptomeningeal metastasis (LM) most commonly arise from breast and lung cancers, and melanoma. Genitourinary cancer (including ovarian, prostate, uterine kidney and bladder) rarely cause LM, with only case reports published. The aims of the study were to describe cases of patients with Genitourinary cancer and Leptomeningeal metastasis, to estimate its prevalence and describe its behavior and outcome. We queried the MD Anderson database for patients with LM and genitourinary cancer between 1978 and 2011. The files of all patients with genitourinary cancer and leptomeningeal disease were retrospectively reviewed. Out of 93960 GU cancer patients treated in MD Anderson (cervix cancer 13,289, ovarian cancer 13,126, bladder cancer 11,834, prostate cancer 41,830, and kidney 13,881), 31 cases (0.03 %) of GU cancer with LM were identified in MD Anderson Cancer Center (MDACC) between 1978 and 2011. Eight patients had bladder cancer, 4 had cervical cancer, 4 had renal cancer, 8 had ovarian cancer and 7 had prostate cancer. Mean age of diagnosis of cancer was 55.9 ± 11.7 (range 20-74). Mean time from primary diagnosis to LM diagnosis was 141.46 ± 244 weeks (range 0.43-409.57). Median survival after LM diagnosis was 15.7 weeks (range 0.85-142.57). The patients presented with multiple signs and symptoms. Although rare-LM should be considered as a complication of GU cancer. Awareness of early neurological signs and symptoms may help the clinician to make an early diagnosis and possibly intervene to prevent neurological deficits.

Leptomeningeal Involvement in Prostate Cancer: A Case Report

“…Thus, urologic tumor origin is rare, and exceptional in prostate cancer [5], less than 1% [6]. In our case, first disease manifestation is a biochemical relapse with asymptomatic patient, and CT and bone-scan showing sacral and left sacral-iliac osteoblastic affectation.…”

“…This fact seems very relevant according to two aspects. Firstly, in reviewed literature are described possible mechanisms of invasion that are present in solid tumors at higher levels in leptomeningeal location when beginning is sacrum, or blood spread or direct involvement of intra-dural extra-cord component [5,10] which would explain our case. And secondly, this figure is not described in the reviewed literature in any prostate cancer, so we consider that is a singular fact different from the published ones before and, in our opinion, could be one step closer to progression of disease.…”

ecancermedicalscience

“…There has been a recent rise in the diagnosis of leptomeningeal metastasis partly because of increased survival and also because of aggressive diagnostic modalities in pursuit of the diagnosis [3–5]. Association of LMC with RCC is a rare entity, with very few cases reported in the literature.…”

“…Haematopoietic cancers like lymphoma (7–15%) and leukaemia (5–15%) also contribute to a significant number of cases of leptomeningeal metastasis. Primary brain tumours contribute to about 1–2% of cases [3–8]. …”

“…Increased cell adhesion can lead to the formation of bulky masses. Even in the absence of gross evidence of disease, there can be microscopic evidence of disseminated tumour involvement of the leptomeninges throughout the central nervous system [3–8]. …”