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Early detection and treatment are critical for improving the prognosis of patients with leptomeningeal metastasis. However, heterogeneous clinical manifestations, non-specific imaging, and limited sensitivity of cerebrospinal fluid cytology posed challenges to identifying leptomeningeal metastasis in the early stage. Here we reported a case of lung adenocarcinoma complaining of rapid cognitive decline, whose magnetic resonance imaging showed interstitial brain edema. Under the circumstances of negative cerebrospinal fluid cytology, metagenome next-generation sequencing and copy number variations analysis were applied, which indicated leptomeningeal metastasis and was confirmed in the subsequent cytology.
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http://dx.doi.org/10.1002/ccr3.9676 | DOI Listing |
Curr Med Imaging
September 2025
Department of Pharmacy, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China.
Unlabelled: Leptomeningeal metastasis (LM) is a severe complication of solid malignancies, including lung adenocarcinoma, characterized by poor prognosis and diagnostic challenges. This study assesses whether curvilinear peri-brainstem hyperintense signals on MRI are a characteristic feature of LM in lung adenocarcinoma patients.
Methods: This retrospective study analyzed data from multiple centers, encompassing lung adenocarcinoma patients with peri-brainstem curvilinear hyperintense signals on MRI between January 2016 and March 2022.
Cancer Manag Res
September 2025
The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
Background: Lung cancer brain metastasis (LCBM) accounts for 40-50% of intracranial malignancies, with emerging evidence of alternative metastatic pathways circumventing the blood-brain barrier. Existing prognostic models lack validation in Asian populations and molecular stratification. This multicenter study aimed to develop a clinical nomogram integrating clinicopathological and molecular determinants for personalized LCBM management.
View Article and Find Full Text PDFRadiol Case Rep
November 2025
Radiologist Consultant, Head of Radiology Department, An-Najah National University Hospital, Nablus, Palestine.
Lung cancer, particularly non-small lung cancer (NSCLC), is one of the most common malignant tumors worldwide and is associated with high mortality in advanced stages. Lung adenocarcinoma is the most frequent NSCLC subtype. Among these common metastatic sites, brain metastases and leptomeningeal metastases have a particularly debilitating impact on patients' survival and quality of life.
View Article and Find Full Text PDFJAMA Oncol
September 2025
Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York.
Importance: Leptomeningeal metastasis (LM) is associated with limited survival and few treatment options. Photon involved-field radiotherapy (IFRT) is the most common radiotherapy treatment for patients with LM from solid tumors.
Objective: To assess whether proton craniospinal irradiation (pCSI) would result in superior central nervous system progression-free survival (CNS-PFS) compared with IFRT.
Neuro Oncol
August 2025
Department of Neuro-Oncology. Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, US.
Background: Leptomeningeal disease (LMD) from solid tumors has a dismal prognosis, even following treatment with anti-PD-1 therapy. We performed a phase IB study evaluating the safety of Avelumab with whole brain radiotherapy (WBRT) in LMD (NCT03719768).
Methods: Fifteen patients were enrolled with LMD from breast, lung, nasopharyngeal, ovary, and pancreatic tumors.