Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Georgios Rigakos, MD; Chrysoula I. Liakou, MD; Naillid Felipe, Dennis Orkoulas-Razis, MHS; Evangelia Razis, MD, PhD


Cancer Control. 2017;24(1):9-21. 

In This Article


In many cases, neoplastic meningitis presents with various neurological symptoms that are not always attributable to a single area of the central nervous system. Although the disease must be differentiated from paraneoplastic and infectious syndromes, the diagnosis is not difficult to identify in a patient with advanced malignancy. However, a definitive diagnosis is more elusive, because both radiology and cytology findings of the cerebrospinal fluid may not yield adequate proof of neoplastic meningitis. Persistence on the part of the clinician is required so that the diagnosis can be established and therapy can be initiated. The complexity of establishing the diagnosis cannot be understated, as multiple false-negative results on cytology and imaging may not necessarily exclude neoplastic meningitis. Thus, the diagnosis may depend on clinical judgment and experience.[6] To help aid in the diagnosis, newer techniques are being investigated to facilitate the diagnostic process.