Primary diffuse leptomeningeal gliomatosis

Gregory A. Jicha, Janel Glantz, Michelle J. Clarke, Lenora M. Lehwald, David P. Russo, Caterina Giannini, John T. Wald, Joon Uhm, Neeraj Kumar, Allen Jr. Aksamit, Cynthia J. Wetmore

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare presentation of a primary central nervous system glial tumor. Methods: Four case reports of PDLG in young males aged 14-24 years are presented. These reports are discussed in the context of the existing literature. Results: The clinical presentation of 4 new cases of PDLG resembled chronic meningitis with and without polyradiculopathy. Spinal fluid studies are typically nondiagnostic, but characteristically show elevated opening pressure, an elevated protein level, and a relative paucity of cellular reaction. An accurate antemortem diagnosis required contrast-enhanced imaging and meningeal biopsy in all 4 of our cases. Treatment strategies including craniospinal radiation and chemotherapeutic approaches, alone or in combination, have not been proven to alter the course of the disease. Initial responses to temozolomide and radiation treatments in all 4 of our cases were promising, resulting in temporary stabilization of the disease and prolonging life expectancy over what was previously reported in the literature. Conclusion: Total neuroaxis contrast-enhanced MRI scanning is required for directing biopsy confirmation and detecting the extent of the disease. More effective therapeutic strategies are needed, but the combination of temozolomide and radiation therapy may slow disease progression.

Original languageEnglish (US)
Pages (from-to)16-22
Number of pages7
JournalEuropean Neurology
Volume62
Issue number1
DOIs
StatePublished - Jun 2009

Fingerprint

temozolomide
Polyradiculopathy
Radiation
Biopsy
Central Nervous System Neoplasms
Life Expectancy
Meningitis
Neuroglia
Disease Progression
Radiotherapy
Therapeutics
Pressure
Proteins

Keywords

  • Chronic meningitis
  • Glioma
  • Meningeal neoplasms
  • Primary diffuse leptomeningeal gliomatosis
  • Temozolomide

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Jicha, G. A., Glantz, J., Clarke, M. J., Lehwald, L. M., Russo, D. P., Giannini, C., ... Wetmore, C. J. (2009). Primary diffuse leptomeningeal gliomatosis. European Neurology, 62(1), 16-22. https://doi.org/10.1159/000216838

Primary diffuse leptomeningeal gliomatosis. / Jicha, Gregory A.; Glantz, Janel; Clarke, Michelle J.; Lehwald, Lenora M.; Russo, David P.; Giannini, Caterina; Wald, John T.; Uhm, Joon; Kumar, Neeraj; Aksamit, Allen Jr.; Wetmore, Cynthia J.

In: European Neurology, Vol. 62, No. 1, 06.2009, p. 16-22.

Research output: Contribution to journalArticle

Jicha, GA, Glantz, J, Clarke, MJ, Lehwald, LM, Russo, DP, Giannini, C, Wald, JT, Uhm, J, Kumar, N, Aksamit, AJ & Wetmore, CJ 2009, 'Primary diffuse leptomeningeal gliomatosis', European Neurology, vol. 62, no. 1, pp. 16-22. https://doi.org/10.1159/000216838
Jicha GA, Glantz J, Clarke MJ, Lehwald LM, Russo DP, Giannini C et al. Primary diffuse leptomeningeal gliomatosis. European Neurology. 2009 Jun;62(1):16-22. https://doi.org/10.1159/000216838
Jicha, Gregory A. ; Glantz, Janel ; Clarke, Michelle J. ; Lehwald, Lenora M. ; Russo, David P. ; Giannini, Caterina ; Wald, John T. ; Uhm, Joon ; Kumar, Neeraj ; Aksamit, Allen Jr. ; Wetmore, Cynthia J. / Primary diffuse leptomeningeal gliomatosis. In: European Neurology. 2009 ; Vol. 62, No. 1. pp. 16-22.
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