Aggressive treatment with complete remission in primary diffuse leptomeningeal gliomatosis--a case report

J Neurooncol. 1998 Apr;37(2):161-7. doi: 10.1023/a:1005888319228.

Abstract

Primary leptomeningeal gliomatosis is rare, and the diffuse form (PLDG) is even more unusual. The following report is an example. A 17 year-old man developed a syndrome characterized by extensive basal and chronic spinal meningitis. Routine biological tests showed elevated levels of CSF proteins, and moderate mononuclear pleocytosis, with no direct evidence of neoplasia, leading to a diagnosis of chronic meningitis. A second meningeal biopsy, guided by MRI and performed in the left frontal region, led to the specific diagnosis of primary diffuse leptomeningeal gliomatosis. Treatment including ventricular and lumbar shunting, a course of cortico-spinal radiation, and three courses of an eight-drug systemic chemotherapy with intrathecal methotrexate lead to complete remission over 15 months. We believe that this is the first report of such a remission in the literature.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Antimetabolites, Antineoplastic / therapeutic use
  • Cerebrospinal Fluid Shunts
  • Combined Modality Therapy
  • Glioma / diagnosis
  • Glioma / radiotherapy
  • Glioma / therapy*
  • Humans
  • Injections, Spinal
  • Male
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / radiotherapy
  • Meningeal Neoplasms / therapy*
  • Methotrexate / therapeutic use
  • Remission Induction

Substances

  • Antimetabolites, Antineoplastic
  • Methotrexate